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目的探讨支气管肺泡灌洗(BAL)在弥漫性肺实质疾病(DPLD)预后评估中的价值。方法回顾分析57例DPLD患者临床资料及支气管肺泡灌洗液(BALF)结果,对该组患者进行随访,观察BALF中细胞成分与预后的关系。结果本组患者中,男33例,女24例,24～79岁,平均(62±13)岁,其中特发性肺间质纤维化(IPF)10例,隐源性机化性肺炎(COP)9例,非特异性间质性肺炎(NSIP)12例,过敏性肺炎(HP)10例,胶原血管病所致间质性肺病(CVD-ILD)16例,病情缓解29例,加重10例,死亡18例;淋巴细胞比例与中性粒细胞比例与生存时间的Cox回归分析显示淋巴细胞百分比为保护因素(OR=0.948,95%CI0.914～0.991,P=0.019)。中性粒细胞百分比为危险因素(OR=1.024,95%CI0.997～1.042,P=0.065)。结论 BAL在DPLD预后评估中具有重要价值,淋巴细胞增高为保护因素,中性粒细胞增高为危险因素。
Objective To investigate the value of bronchoalveolar lavage (BAL) in the prognosis of diffuse pulmonary parenchymal disease (DPLD). Methods A retrospective analysis of 57 cases of DPLD patients with clinical data and bronchoalveolar lavage fluid (BALF) results were followed up in this group of patients to observe the relationship between cellular composition and prognosis of BALF. Results In this group of patients, 33 males and 24 females, aged 24 to 79 years, with an average of (62 ± 13) years, of which idiopathic pulmonary fibrosis (IPF) in 10 cases, cryptogenic organic pneumonia COP) in 9 cases, nonspecific interstitial pneumonia (NSIP) in 12 cases, allergic pneumonia (HP) in 10 cases, collagen vascular disease caused by interstitial lung disease (CVD-ILD) in 16 cases, remission in 29 cases, increased 10 Cox regression analysis showed that lymphocyte percentage was a protective factor (OR = 0.948, 95% CI: 0.941-0.991, P = 0.019). Neutrophil percentage was a risk factor (OR = 1.024, 95% CI 0.997 to 1.042, P = 0.065). Conclusion BAL plays an important role in the prognosis evaluation of DPLD. Lymphocyte proliferation is a protective factor and neutrophil increase is a risk factor.