论文部分内容阅读
探讨特发性肺纤维化（ＩＰＦ）经支气管肺活检（ＴＢＬＢ）组织胶原分型测定的临床意义。方法对２５例ＩＰＦ患者ＴＢＬＢ标本和１０例正常肺组织应用免疫组化染色法，进行Ⅰ型和Ⅲ型胶原（ＣｏｌⅠ和ＣｏｌⅢ）的半定量测定；并检测１３例的支气管肺泡灌洗液（ＢＡＬＦ）的细胞成分，随访１７例激素疗效，结合病程和病变程度进行综合分析。结果ＩＰＦ肺组织Ⅰ、Ⅲ型胶原沉积量较正常肺组织不同程度增多；病程短（≤３月）、病变程度轻（Ⅰ、Ⅱ级）者，肺组织中ＣｏｌⅢ占优势，病程长（＞２４月）、病变较重（Ⅲ、Ⅳ级）者，则以ＣｏｌⅠ为主；治疗有效组，ＣｏｌⅢ／ＣｏｌⅠ≥１，无效组ＣｏｌⅢ／ＣｏｌⅠ＜１（Ｐ＜０．０１）；ＣｏｌⅢ／ＣｏｌⅠ≥１者，ＢＡＬＦ中性粒细胞百分比明显增高（Ｐ＜０．０５）。结论多部位取材ＴＢＬＢ标本进行胶原分型测定和比例分析，可以较好地辅助判断ＩＰＦ病变程度和活动性。
To investigate the clinical significance of the determination of collagen type in idiopathic pulmonary fibrosis (IPF) by bronchoscopic lung biopsy (TBLB). Methods Immunohistochemical staining was performed on TBLB specimens of 10 IPF patients and 10 normal lung tissues for semiquantitative determination of type Ⅰ and type Ⅲ collagen (ColⅠ and Col Ⅲ). Bronchoalveolar lavage fluid (BALF ) Cell components, follow-up of 17 cases of hormone therapy, combined with the duration and severity of a comprehensive analysis. Results Compared with normal lung tissue, the deposition of type Ⅰ and type Ⅲ collagen in IPF lung tissue increased at different degrees. The duration of disease was shorter (≤ 3 months), and the degree of lesion was lower (grade Ⅰ and Ⅱ) Col Ⅲ / ColⅠ≥1, Col Ⅲ / ColⅠ <1 (P <0.01), Col Ⅲ / ColⅠ≥1 , The percentage of BALF neutrophils was significantly increased (P <0.05). Conclusion The TBLB specimens from multiple sites can be used to determine the type and proportion of IPF lesions.