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首页> 外文期刊>Journal of clinical rheumatology >Role of bronchoalveolar lavage for diagnosing pulmonary infection in patients with rheumatic autoimmune diseases and lung infiltrates
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Role of bronchoalveolar lavage for diagnosing pulmonary infection in patients with rheumatic autoimmune diseases and lung infiltrates

机译：支气管肺泡灌洗在风湿性自身免疫性疾病和肺浸润患者中诊断肺部感染的作用

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Objectives: The aims of the study were to evaluate the effectiveness of bronchoalveolar lavage (BAL) for diagnosing pulmonary infection in patients with rheumatic autoimmune diseases and lung infiltrates and to evaluate factors that affect the diagnostic yield.Methods: A retrospective study was performed in patients with rheumatic autoimmune diseases and lung infiltrates whose BALs were sent for microbial assays at Peking Union Medical College Hospital from January 2009 to June 2013. Patient characteristics, clinical symptoms, medication history, laboratory parameters, radiographic findings, lung lobe lavaged, and diagnostic yield were retrieved.Results: Seventy BALs were performed in 69 patients. The overall diagnostic yield of BAL for pulmonary infectionwas 17.1%(12/70), sensitivity was 35.5%, and specificity was 97.4%. Twelve microorganisms were isolated from 12 different BALs conforming to diagnostic criteria, including 4 Aspergillus, 3 Pneumocystis jirovecii, 3 gram-negative bacilli, 1 grampositive coccus, and 1 mycobacterium. Patients with clinical symptoms of fever, cough, or expectoration had a higher diagnostic yield than patients without either symptom (25.6% vs 3.7%, P = 0.042). Patients with groundglass opacity,mass, or consolidation radiographically had a higher yield than did patients with reticular or nodular infiltrates (20.3% vs 0, P < 0.001).Conclusions: Bronchoalveolar lavage is a useful tool for patients with rheumatic autoimmune diseases and lung infiltrates, especially in cases where initial antimicrobial therapy is ineffective. Opportunistic pathogens are important in patients with rheumatic autoimmune diseases and lung infiltrates and should be considered when antibacterial treatment is ineffective.
机译：目的：本研究旨在评估支气管肺泡灌洗（BAL）在风湿性自身免疫疾病和肺浸润患者中诊断肺部感染的有效性，并评估影响诊断率的因素。方法：对患者进行回顾性研究。自2009年1月至2013年6月在北京协和医院对风湿性自身免疫性疾病和肺浸润患者的BAL进行了微生物检测。结果：69例患者进行了70次BAL检查。 BAL对肺部感染的总诊断率为17.1％（12/70），敏感性为35.5％，特异性为97.4％。从符合诊断标准的12种不同的BAL中分离出12种微生物，包括4曲霉菌，3支耶氏肺孢菌，3克阴性杆菌，1革兰氏阳性球菌和1支分枝杆菌。具有发烧，咳嗽或咳痰的临床症状的患者比无任何症状的患者具有更高的诊断率（25.6％vs 3.7％，P = 0.042）。影像学上不透明，质量大或结扎的患者比网状或结节性浸润的患者具有更高的收率（20.3％vs 0，P <0.001）。 ，尤其是在最初的抗菌治疗无效的情况下。风湿性自身免疫性疾病和肺部浸润患者中机会病原体很重要，当抗菌治疗无效时应考虑使用。

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