Pulmonary accumulation of polymorphonuclear leukocytes in the adult respiratory distress syndrome
Pulmonary accumulation of polymorphonuclear leukocytes in the adult respiratory distress syndrome
复制标题
成人呼吸窘迫综合征中多形核白细胞的肺部积聚
作者：
J. Powe;A. Short;W. Sibbald;A. Driedger
多形核白细胞（PMN）在成人呼吸窘迫综合征（ARDS）相关的通透性肺水肿的发展中起着不可或缺的作用。本报告描述了3例继发于全身性败血症的ARDS患者，他们表现出肺中铟（111In）标记的PMNs的异常弥漫性积聚，没有伴有原发性胸部感染的临床或实验室证据。在一名患者中，最初通过时肺部活动的积累表明这种观察与肺微血管内弥漫性白细胞聚集有关。在一项类似的研究中，第4例ARDS患者服用了高剂量的皮质类固醇，并没有显示肺部pmn积聚，这可能是皮质类固醇对人类ARDS有益作用的原因。
The polymorphonuclear leukocyte (PMN) plays an integral role in the development of permeability pulmonary edema associated with the adult respiratory distress syndrome (ARDS). This report describes 3 patients with ARDS secondary to systemic sepsis who demonstrated an abnormal diffuse accumulation of Indium (111In)-labeled PMNs in their lungs, without concomitant clinical or laboratory evidence of a primary chest infection. In one patient, the accumulation of the pulmonary activity during an initial pass suggested that this observation was related to diffuse leukoaggregation within the pulmonary microvasculature. A 4th patient with ARDS was on high-dose corticosteroids at the time of a similar study, and showed no pulmonary accumulation of PMNs, suggesting a possible reason for the reported beneficial effect of corticosteroids in human ARDS.