High-altitude pulmonary edema. Characteristics of lung lavage fluid.
High-altitude pulmonary edema. Characteristics of lung lavage fluid.
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DOI：
10.1001/jama.1986.03380010067027
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发表时间：
1986-07
期刊：
影响因子：
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通讯作者：
R. Schoene;P. Hackett;P. Hackett;W. Henderson;E. Sage;Marguerite Chow;R. Roach;W. Mills;T. Martin
中科院分区：
文献类型：
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作者：
R. Schoene;P. Hackett;P. Hackett;W. Henderson;E. Sage;Marguerite Chow;R. Roach;W. Mills;T. Martin
为了评估高海拔肺水肿（HAPE）中支气管肺泡液的细胞和生化成分，我们在麦金利山海拔4400米的研究设施中对三名患有HAPE的登山者进行了支气管肺泡灌洗。三名健康的登山者被用作对照。HAPE液体中的高分子量蛋白质、红细胞和白细胞显著增加，其中大部分是肺泡巨噬细胞。HAPE液体还含有可检测量的白三烯B4和花生四烯酸代谢的其他脂氧合酶产物、补体片段（C5 a）、中性粒细胞趋化性抑制剂和酸性蛋白酶，但不含胶原蛋白的组成成分羟脯氨酸。本研究的数据表明，HAPE涉及肺循环中的瞬时“大孔”泄漏。尽管存在两种有效的炎症介质，白三烯B4和C5 a，但HAPE的特征不在于其他形式的急性肺损伤所特有的强烈的中性粒细胞积聚。（JAMA 1986;256：63-69）
To evaluate the cellular and biochemical composition of bronchoalveolar fluid in high-altitude pulmonary edema (HAPE), we performed bronchoalveolar lavage in three climbers with HAPE in a research facility at 4400 m on Mount McKinley. Three healthy climbers were used as controls. The HAPE fluids contained marked increases in high-molecular-weight proteins, erythrocytes, and leukocytes, most of which were alveolar macrophages. The HAPE fluids also contained detectable amounts of leukotriene B4 and other lipoxygenase products of arachidonic acid metabolism, complement fragments (C5a), inhibitors of neutrophil chemotaxis, and acid proteases but not hydroxyproline, a constituent of collagen. The data from this study indicate that HAPE involves a transient "large pore" leak in the pulmonary circulation. Despite the presence of two potent mediators of inflammation, leukotriene B4and C5a, HAPE is not characterized by the intense neutrophil accumulation that is typical of other forms of acute lung injury. (JAMA1986;256:63-69)