DECREASED SURFACTANT PROTEIN-A IN PATIENTS WITH BACTERIAL PNEUMONIA
DECREASED SURFACTANT PROTEIN-A IN PATIENTS WITH BACTERIAL PNEUMONIA
复制标题
DOI：
10.1164/ajrccm/147.3.653
复制
发表时间：
1993-03-01
期刊：
影响因子：
--
通讯作者：
WHITSETT, J
中科院分区：
文献类型：
--
作者：
BAUGHMAN, RP;STERNBERG, RI;WHITSETT, J
先前已注意到细菌性肺炎患者灌洗液的脂质含量降低。为了确定这些变化是否也见于表面活性物质载脂蛋白，我们研究了细菌性肺炎患者表面活性物质蛋白A（SP-A）的水平。正在评估肺浸润的无人类免疫缺陷病毒的患者接受支气管镜检查和支气管肺泡灌洗（BAL）。将22例肺炎患者（12例由革兰氏阳性菌（Gm+ PNEU）引起，10例由革兰氏阴性菌（Gm-PNEU）引起）与10例特发性肺纤维化（IPF）患者和11例对照受试者（CON）进行比较。IPF和肺炎组患者的BAL中中性粒细胞百分比显著高于对照组（CON：平均值为1;范围为0 - 3。IPF：平均值：26;范围：13 - 42）。Gm+ PNEU：平均值为33;范围为8 - 99。Gm-PNEU：平均值64;范围10 - 92; p < 0.0001）。CON组和IPF组BAL液中SP-A的含量相似（CON：平均值为15;范围为5.75 - 26.5 μ g/ml BAL。IPF：平均值，18.4;范围，6.49 - 45.64 μ g/ml），而两个肺炎组的SP-A显著更少（Gm-PNEU：平均值，5.54;范围，0.58 - 12.7）。G+ PNEU：平均值，1.93;范围，0.47至6.74; p < 0.001）。Gm+ PNEU组SP-A含量明显低于Gm-PNEU组（p < 0.02）。我们的结论是，有一个降低的量的SP-A在BAL液中的细菌性肺炎患者和Gm+微生物引起更大的减少SP-A。
Abnormalities have been previously noted in the lipid content of the lavage fluid of patients with bacterial pneumonia. In order to determine if these changes were also seen in surfactant apoproteins, we studied levels of surfactant protein A (SP-A) in patients with bacterial pneumonia. Patients without human immunodeficiency virus who were being evaluated for pulmonary infiltrates underwent bronchoscopy with bronchoalveolar lavage (BAL). Twenty-two patients with pneumonia, 12 caused by gram-positive organisms (Gm+ PNEU) and 10 caused by gram-negative organisms (Gm- PNEU), were compared with 10 patients with idiopathic pulmonary fibrosis (IPF) and 11 control subjects (CON). The percentage of neutrophils in the BAL was significantly higher in the patients with IPF and the pneumonia groups than in the control group (CON: mean, 1; range, 0 to 3. IPF: mean, 26; range, 13 to 42). Gm+ PNEU: mean, 33; range, 8 to 99. Gm- PNEU: mean, 64; range, 10 to 92; p < 0.0001). The amount of SP-A in the BAL fluid was similar for the CON and the IPF groups (CON: mean, 15; range, 5.75 to 26.5 mug/ml BAL. IPF: mean, 18.4; range, 6.49 to 45.64 mug/ml), whereas both pneumonia groups had significantly less SP-A (Gm- PNEU: mean, 5.54; range, 0.58 to 12.7. G+ PNEU: mean, 1.93; range, 0.47 to 6.74; p < 0.001). There was significantly less SP-A in the Gm+ PNEU group than in the Gm- PNEU group (p < 0.02). We conclude that there is a lowering of the amount of SP-A in the BAL fluid in patients with bacterial pneumonia and that Gm+ organisms cause a larger reduction of the SP-A.