Safety of research bronchoscopy, biopsy and bronchoalveolar lavage in asthma
Safety of research bronchoscopy, biopsy and bronchoalveolar lavage in asthma
复制标题
DOI：
10.1183/09031936.04.00063003
复制
发表时间：
2004-09-01
影响因子：
24.3
通讯作者：
Barnes, NC
中科院分区：
文献类型：
--
作者：
Elston, WJ;Whittaker, AJ;Barnes, NC
支气管镜与支气管内活检（EBB）和/或支气管肺泡灌洗（BAL）已成为哮喘研究的重要工具。最近的一份报告建议对这些程序的安全性进行审计和报告。共有159例哮喘患者（男84例，女75例）在6项临床研究中接受了273次支气管镜检查，年龄18-52岁（中位27）岁，预计每秒用力呼气量53-120（中位88）%。228例患者同时行EBB和BAL， 45例患者单独行EBB。48例患者在过敏原激发后24小时进行支气管镜检查。273例中有34例发生了不良事件，没有一例是在过敏原攻击后发生的。术后4例患者出现胸膜炎性胸痛、呼吸急促和发热。另有两名患者仅在ebb /BAL后出现胸膜炎性胸痛。支气管痉挛或哮喘症状恶化发生14次，13次在ebb /BAL后发生，1次单独在ebb后发生。发热/流感样症状在EBB和BAL后报告了9例。一名受试者在ebb /BAL后出现咯血，但不需要干预。总之，支气管镜检查、支气管内活检和支气管肺泡灌洗对哮喘患者是安全的。大多数并发症发生在同时进行支气管肺泡灌洗和支气管内活检的地方，这表明支气管肺泡灌洗是大多数不良事件的原因。
Bronchoscopy with endobronchial biopsy (EBB) and/or bronchoalveolar lavage (BAL) has become an important research tool in asthma. A recent report has suggested audit and reporting of the safety of these procedures.A total of 159 asthmatic patients (84 males, 75 females), aged 18-52 (median 27) yrs, forced expiratory volume in one second 53-120 (median 88) % predicted, underwent 273 bronchoscopies in six clinical research studies. On 228 occasions, EBB and BAL were performed and, on 45 occasions, EBB was performed alone. On 48 occasions, bronchoscopy was performed 24 h post-allergen challenge.Adverse events occurred on 34 out of 273 occasions, none of which were following allergen challenge. Post-EBB and BAL, four patients developed pleuritic chest pain, shortness of breath and fever. A further two patients experienced pleuritic chest pain alone post-EBB/BAL. Bronchospasm or worsening of asthma symptoms occurred on 14 occasions, 13 post-EBB/BAL and on one occasion post-EBB alone. Fever/flu-like symptoms were reported on nine occasions following EBB and BAL. One subject had haemoptysis post-EBB/BAL, but required no intervention.In conclusion, bronchoscopy, endobronchial biopsy and bronchoalveolar lavage can be performed safely in asthmatic patients. Most of the complications were seen where bronchoalveolar lavage and endobronchial biopsy were both performed, suggesting that bronchoalveolar lavage accounts for most of the adverse events.