SURFACTANT METABOLISM IN AIDS PATIENTS WITH PNEUMOCYSTIS CARINII PNEUMONIA

患者低氧血症和气体交换下降的机制 与治疗和未治疗的肺炎由于肺孢子虫是不干净的。 表面活性剂脂质的微量测定技术 研制出支气管肺泡灌洗液。在初步 研究了29个样本。有证据表明表面活性剂脂质 溶血磷脂酰胆碱增加而分解。还有 有证据表明，灌洗液中磷脂酶A2活性增加， 这些病人。这篇论文发表于1992年。的重要性 这些研究表明，这些观测结果可能有助于发展 新的或不同的治疗方法。本研究 已扩展到评价皮质类固醇的作用 给药对HIV感染者BAL中表面活性物质脂质水平的影响 肺孢子虫肺炎患者。在BAL的纵向研究中， 肺表面活性物质在卡氏肺孢子虫肺炎中作用 在第10天测量表面活性剂二棕榈酰磷脂酰胆碱（DPPC） 第0天和第10天，使用毛细管柱气相色谱仪。BAL DPPC 接受连续性皮质类固醇治疗的患者的水平 与那些没有接受这种治疗的人相比。BAL表面活性剂PC 两组第0天的水平均降低（约为正常值的25%） 并在第10天恢复正常。无差异 第0天和第10天的组目前的研究重点是变化， 在治疗开始后第3-5天在BAL表面活性剂DPPC中。这 研究表明，肺表面活性物质脂质减少， 它提高了新方法的可能性， 卡氏肺孢子虫致呼吸衰竭的治疗

The mechanisms of hypoxemia and of declining gas exchange in patients with treated and untreated pneumonia due to pneumocystis is not clean. A microtechnique for the measurement of surfactant lipids from Bronchoalveolar Lavage Fluid has been developed. In a preliminary study, 29 samples were studied. There is evidence of surfactant lipid breakdown with an increase in lysophosphatidyl choline. There is also evidence of increased Phospholipase A2 activity in the lavage fluid of these patients. This paper was published in 1992. The importance of these studies is that these observations may allow for the development of new or different therapies in this patient population. This study has been extended to evaluate the effect of corticosteroid administration on surfactant lipid levels in the BAL of HIV infected patients with Pneumocystis pneumonia. In a longitudinal study of BAL surfactant in patients with pneumocystis carinii pneumonia, BAL surfactant dipalmitoyl phosphatidyl choline (DPPC) was measured at Day 0 and Day 10 using a capillary column gas chromatograph. The BAL DPPC levels of patients receiving adjunctive corticosteroid therapy were compared to those not receiving this therapy. The BAL surfactant PC levels were depressed (about 25% of normal) at Day 0 in both groups and returned toward normal by Day 10. There was no difference between the groups at Day O and Day 10 current studies are focusing on changes in BAL surfactant DPPC at day 3-5 after initiation of therapy. This study demonstrates a reduction in pulmonary surfactant lipid in patients with pneumonia It raises the possibility of new approaches to the therapy of respiratory failure due to pneumocystis carinii.