【摘要】 目的 为更好地了解支气管肺泡灌洗液(BALF)中NK细胞的生物学特性，进一步认识纤维化间质性肺疾病(f-ILDs)的发病机制和开发前瞻性的靶向治疗，分析182例不同类型f-ILDs患者(f-HP、IPF、f-NSIP和CTD-ILD)BALF中细胞计数及淋巴细胞免疫表型，以评估NK和NKT细胞的百分比潜在的诊断、预后作用。方法 本研究纳入2015年1月—2021年10月在湖州市中心医院呼吸内科就诊的182例f-ILDs患者，依据不同类型分4组(f-HP组36例、IPF组62例、f-NSIP组38例、CTD-ILD组46例),进行肺功能检查，并对其BALF进行细胞计数及淋巴细胞免疫表型分析。结果 IPF组患者的BALF中，NK细胞百分比明显高于其他3组(P<0.05),根据NK细胞(临界值3.5%)分层的IPF患者的生存分析结果显示，IPF患者的生存率有明显的差异，差异均有统计学意义(P<0.001)。结论 BALF中NK细胞的百分比可能是预后的标志，IPF患者诊断时BALF中NK细胞百分比的增加可能影响患者的存活率。更多还原

【Abstract】 Objective In order to better understand the biology of NK cells in bronchoalveolar lavage fluid(BALF), further understand the pathogenesis of fibrotic interstitial lung diseases(f-ILDs) and develop prospective targeted therapies, this study aims to analyze cell counts and lymphocyte immunophenotypes in BALF of 182 patients with different types of f-ILDs(f-HP, IPF, f-NSIP and CTD-ILD) and to assess the potential diagnostic/prognostic role of the percentage of NK and NKT-like cells. Methods This study included 182 patients with f-ILDs who attended the respiratory medicine department of Huzhou Central Hospital between January 2015 and December 2020. These cases were divided into 4 groups according to different types of f-ILDs(36 patients in the f-HP group, 62 patients in the IPF group, 38 patients in the f-NSIP group, and 46 patients in the CTD-ILD group), who underwent pulmonary function tests and had their BALF analyzed for cell counts and lymphocyte immunophenotyping. Results The percentage of NK cells in the BALF of patients in the IPF group was significantly higher than in the other three groups(P<0.05), and survival analysis of IPF patients stratified according to NK cells(critical value 3.5%) showed a significant difference in survival rate, with the difference statistically significant(P<0.001). Conclusion The percentage of NK cells in BALF may be a marker of prognosis, and an increase in the percentage of NK cells in BALF at the time of diagnosis in patients with IPF may affect the survival rate of patients.更多还原