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首页> 外文期刊>Respiration: International Review of Thoracic Diseases >A Comparative Study of Bronchoscopic Microsample Probe versus Bronchoalveolar Lavage in Patients with Burns-Related Inhalational Injury, Acute Lung Injury and Chronic Stable Lung Disease
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A Comparative Study of Bronchoscopic Microsample Probe versus Bronchoalveolar Lavage in Patients with Burns-Related Inhalational Injury, Acute Lung Injury and Chronic Stable Lung Disease

机译：烧伤相关吸入性损伤，急性肺损伤和慢性稳定肺疾病患者的支气管镜显微样品探针与支气管肺泡灌洗的比较研究

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Background and Objectives: The bronchoscopic microsample (BMS) probe allows direct epithelial lining fluid (ELF) level measurement without saline lavage. We investigated whether cytokine levels in ELF from a BMS differed from those obtained by bronchoalveolar lavage (BAL) in stable and acute lung disease. Methods: In a single-centre, prospective observational cohort study of 45 patients, a sequential BMS probe procedure and BAL were performed on patients with stable chronic obstructive lung disease, interstitial lung disease, acute lung injury (ALI), burns-related inhalational injury or controls. ELF samples were assayed for IL-1 beta, IL-6, IL-8, TNF-alpha and G-CSF. Results: Both bronchoscopic microsampling and BAL showed significantly higher cytokine levels in the ELF from patients with ALI and burns-related inhalational injury than from those with chronic stable lung disease. The BMS method detected cytokine levels approximately 20- to 80-fold higher than the corresponding BAL (uncorrected for dilution). The ratio of BMS and BAL cytokine levels was as follows: the ratio for IL-1 alpha [mean 55, 95% confidence interval (CI) 34-88] was higher than that for IL-6 (mean 16, 95% CI 10-23, p = 0.015) and IL-8 (mean 13, 95% CI -5 to 36, p = 0.03). The ratio for G-CSF (mean 43, 95% CI 24-75) was higher than that for IL-6 (mean 16, 95% CI 10-23, p = 0.008). Conclusions: The BMS probe safely collects ELF with higher equivalent inflammatory cytokine concentrations than via BAL from patients with both acute and chronic lung disease and can be an alternative to saline BAL. Variations in cytokine concentrations between BMS and BAL and sampling-site differences warrant further study. (C) 2015 S. Karger AG, Basel
机译：背景与目的：支气管镜显微样品（BMS）探针可直接测量上皮衬里液（ELF）水平，而无需盐水冲洗。我们调查了在稳定和急性肺部疾病中，来自BMS的ELF中的细胞因子水平是否不同于通过支气管肺泡灌洗（BAL）获得的水平。方法：在一项对45名患者进行的单中心，前瞻性观察队列研究中，对稳定的慢性阻塞性肺疾病，间质性肺疾病，急性肺损伤（ALI），烧伤相关的吸入性损伤的患者进行了顺序BMS探查程序和BAL或控件。测定ELF样品的IL-1β，IL-6，IL-8，TNF-α和G-CSF。结果：ALI和烧伤相关的吸入性损伤患者的支气管镜显微采样和BAL均显示ELF中的细胞因子水平明显高于慢性稳定肺疾病患者。 BMS方法检测到的细胞因子水平比相应的BAL高约20至80倍（未经稀释稀释）。 BMS和BAL细胞因子水平的比率如下：IL-1 alpha的比率[平均值55，95％置信区间（CI）34-88]高于IL-6（平均值16，95％CI 10 -23，p ＝ 0.015）和IL-8（平均值13，95％CI -5至36，p ＝ 0.03）。 G-CSF的比率（平均43，95％CI 24-75）高于IL-6（平均16，95％CI 10-23，p = 0.008）。结论：BMS探针可从急性和慢性肺病患者安全地收集比通过BAL具有更高的等效炎症细胞因子浓度的ELF，并且可以替代盐水BAL。 BMS和BAL之间的细胞因子浓度变化和采样位点差异值得进一步研究。 （C）2015 S.Karger AG，巴塞尔

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