BRONCHOALVEOLAR LAVAGE IN THE DIAGNOSIS OF DIFFUSE PULMONARY-INFILTRATES IN THE IMMUNOSUPPRESSED HOST
BRONCHOALVEOLAR LAVAGE IN THE DIAGNOSIS OF DIFFUSE PULMONARY-INFILTRATES IN THE IMMUNOSUPPRESSED HOST
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DOI：
10.7326/0003-4819-101-1-1
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发表时间：
1984-01-01
影响因子：
39.2
通讯作者：
ARMSTRONG, D
中科院分区：
文献类型：
--
作者：
STOVER, DE;ZAMAN, MB;ARMSTRONG, D
对97例免疫抑制患者进行了支气管肺泡灌洗诊断肺浸润性病变的研究。在免疫抑制患者中，可用的诊断程序通常是侵入性的，并且具有可变的产量和严重并发症的可能性。支气管肺泡灌洗的总诊断率为66%（61/92）。它是最有效的诊断机会性感染，包括感染卡氏肺孢子虫（18/22例），巨细胞病毒肺炎（10/12例），真菌性肺炎（5/6例）和分枝杆菌病（4/5例）。该技术还有助于确认肺出血（9例中的7例），但对于诊断恶性肿瘤（22例中的10例）和药物毒性（15例中的6例）用处不大。支气管肺泡灌洗检查与经支气管活检、刷检、冲洗检查在多数疾病的诊断中具有互补性。该手术是安全的，即使是在脑供血不足的患者和那些需要机械辅助的患者中。支气管肺泡灌洗是一个有价值的程序评估肺部疾病的免疫抑制主机。
The usefulness of bronchoalveolar lavage in the diagnosis of pulmonary infiltrates in the immunosuppressed patient was studied in 97 patients. In immunosuppressed patients, the available diagnostic procedures are often invasive and have variable yield and a potential for serious complications. Bronchoalveolar lavage had an overall diagnostic yield of 66% (61 of 92 diseases). It was most effective in the diagnosis of opportunistic infections, including infection with Pneumocystis carinii (18 of 22 cases), cytomegalovirus pneumonia (10 of 12 cases), fungal pneumonia (5 of 6 cases), and mycobacterial disease (4 of 5 cases). The technique was also helpful in confirming pulmonary hemorrhage (7 of 9 cases) but was less useful for diagnosing malignancy (10 of 22 cases) and drug-induced toxicity (6 of 15 cases). Findings of bronchoalveolar lavage were additive with those of transbronchial biopsies, brushings and washings in the diagnosis of most of the diseases. The procedure was safe, even in thrombocytopenic patients and those requiring mechanical ventilatory support. Bronchoalveolar lavage is a valuable procedure for evaluation of pulmonary disease in the immunosuppressed host.