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目的 :探讨肺间质纤维化时血清及支气管肺泡灌洗液一氧化氮水平与病变活动性的关系。方法 :应用生化方法检测 11例特发性肺间质纤维化 (idiopathic pulm onary fibrosis,IPF)、18例结节病患者及 7例健康非吸烟者血清及支气管肺泡灌洗液一氧化氮 (nitric oxide,NO)浓度。结果 :IPF组和结节病组患者支气管肺泡灌洗液 (bro-cho- alveolar lavage fluid,BAL F) NO水平分别为 (12 .6 7± 2 .43) μm ol/ L 和 (14.84± 2 .97) μmol/ L,明显高于对照组的 (9.6 9± 3.5 2 ) μmol/ L(P <0 .0 5 ) ,分别与 BAL F中中性粒细胞百分比和淋巴细胞百分比呈正相关 (r=0 .6 80 6 ,P <0 .0 5和 r =0 .8976 ,P <0 .0 1)。两组患者血清 NO水平低于对照组 ,但无显著差异 ,与动脉血氧分压(Pa O2 )分别呈正相关 (r =0 .70 13,P <0 .0 5和 r =0 .75 96 ,P <0 .0 1)。结节病组 BAL F中 NO水平 14例与 T4/T8呈正相关 (r =0 .6 931,P <0 .0 1) ,10例与血清血管紧张素转换酶呈正相关 (r =0 .7347,P <0 .0 5 )。结论 :NO在肺间质纤维化的病理发生中起重要作用 ,BAL F中 NO的水平可反映疾病的活动性。
Objective: To investigate the relationship between the levels of nitric oxide in serum and bronchoalveolar lavage fluid (BALF) and the pathological changes during interstitial fibrosis. Methods: Eleven patients with idiopathic pulmonary fibrosis (idiopathic pulm onary fibrosis, IPF), 18 patients with sarcoidosis and 7 healthy non-smoker serum and bronchial alveolar lavage fluid nitric oxide (nitric oxide oxide, NO) concentration. Results: The level of NO in bro-cho-alveolar lavage fluid (BALF) of IPF group and sarcoidosis group were (12.67 ± 2.43) μmol / L and (14.84 ± 2) .97) μmol / L was significantly higher than that of the control group (9.69 ± 3.52) μmol / L (P <0.05), which was positively correlated with the percentages of neutrophils and lymphocytes in BALF = 0 .6 80 6, P <0. 05 and r = 0 .8976, P <0. 01). Serum NO levels in both groups were lower than those in the control group, but no significant difference was found between them and PaO2 (r = 0.7013, P <0.05 and r = 0.7596 , P <0. 01). There was a positive correlation between the level of NO in BALF and the level of T4 / T8 in sarcoidosis (r = 0.6931, P <0.01), and the level of serum angiotensin converting enzyme in 10 patients (r = 0.7334 , P <0. 05). Conclusion: NO plays an important role in the pathogenesis of pulmonary fibrosis. The level of NO in BAL F can reflect the activity of the disease.