An Official American Thoracic Society Clinical Practice Guideline: The Clinical Utility of Bronchoalveolar Lavage Cellular Analysis in Interstitial Lung Disease
An Official American Thoracic Society Clinical Practice Guideline: The Clinical Utility of Bronchoalveolar Lavage Cellular Analysis in Interstitial Lung Disease
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DOI：
10.1164/rccm.201202-0320st
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发表时间：
2012-05-01
影响因子：
24.7
通讯作者：
Wood, Brent
中科院分区：
文献类型：
--
作者：
Meyer, Keith C.;Raghu, Ganesh;Wood, Brent
背景资料：支气管肺泡灌洗液（BAL）细胞分析在间质性肺病（ILD）患者诊断和治疗中的临床应用一直是一个争论和争议的主题。美国胸科学会（ATS）赞助了一个国际专家委员会，以检查关于BAL在ILD中的所有相关文献，并提供关于在疑似ILD患者的诊断和管理中使用BAL的建议。BAL有核免疫细胞模式和其他BAL特征在疑似ILD患者中的解释。进行了一项实用的系统综述，以识别1970年至2006年期间发表的与ILD患者中BAL相关的独特引文。在指南制定过程中更新了检索，以纳入截至2011年3月的已发表文献。这是委员会的结论和建议所依据的证据。结果：委员会制定了关于BAL性能和处理以及BAL结果解释的建议。结论：当与全面的临床信息和充分的胸部成像（如胸部高分辨率计算机断层扫描）结合使用时，BAL细胞模式和其他特征经常为疑似ILD患者的诊断评估提供有用的信息。
Background: The clinical utility of bronchoalveolar lavage fluid (BAL) cell analysis for the diagnosis and management of patients with interstitial lung disease (ILD) has been a subject of debate and controversy. The American Thoracic Society (ATS) sponsored a committee of international experts to examine all relevant literature on BAL in ILD and provide recommendations concerning the use of BAL in the diagnosis and management of patients with suspected ILD.Purpose To provide recommendations for (1) the performance and processing of BAL and (2) the interpretation of BAL nucleated immune cell patterns and other BAL characteristics in patients with suspected ILD.Methods: A pragmatic systematic review was performed to identify unique citations related to BAL in patients with ILD that were published between 1970 and 2006. The search was updated during the guideline development process to include published literature through March 2011. This is the evidence upon which the committee's conclusions and recommendations are based.Results: Recommendations for the performance and processing of BAL, as well as the interpretation of BAL findings, were formulated by the committee.Conclusions: When used in conjunction with comprehensive clinical information and adequate thoracic imaging such as high-resolution computed tomography of the thorax, BAL cell patterns and other characteristics frequently provide useful information for the diagnostic evaluation of patients with suspected ILD.