摘要
支气管肺泡灌洗操作方便、快捷、创伤较小,在临床中的应用越来越广泛,已经成为肺部感染性疾病诊断及治疗的一项重要手段。支气管肺泡灌洗液(BALF)定量培养可以减少对呼吸机相关性肺炎(VAP)的过度诊断,但其敏感度在接受抗菌药物治疗的患者中明显下降。近年来采用不同方法测定BALF中真菌抗原已经成为肺播散性真菌感染诊断的重要方法之一,新近研究肯定了BALF中半乳甘露聚糖测定在曲霉菌病诊断中的价值。但对BALF中发现病毒的意义尚不甚清楚。此外,BALF中一些非细胞成分,如可溶性髓样细胞触发受体(TREM)、前炎性细胞因子等也与肺部感染有关。总之,BAL在肺部感染性疾病的病原学诊断、鉴别诊断以及病情评估中具有重要价值。
Bronchoalveolar lavage, a minimally invasive procedure featured by convenience, has been more increasingly applied for the diagnosis and treatment of pulmonary infectious disease. The quantitative culture of bronchoalveolar lavage fluid （BALF） may reduce the probability of overdiagnosis of ventilator-associated pneumonia yet is challenged by a progressively reduced assay sensitivity in patients treated with antimicrobials previously. Various measures for detection of fungal antigen in BALF have recently become one of the pivotal diagnostic methods for pulmonary and disseminated fungal infection. Despite that the galactomannan in BALF has been evidenced to suggest the diagnosis of aspergillosis, the role for assaying virus in BALF remains unclear. Non-cellular components in BALF ,for instance, soluble triggering receptor expressed on myeloid cells （sTREM） and pro-inflammatory cytokines, may herald pulmonary infectious diseases. In conclusion, BAL plays an important role in etiological diagnosis, differential diagnosis and prognosis of pulmonary infectious disease.
出处
《中国实用内科杂志》
CAS
CSCD
北大核心
2013年第2期119-123,共5页
Chinese Journal of Practical Internal Medicine
关键词
支气管肺泡灌洗
肺
感染
bronchoalveolar lavage
pulmonary
infection
