<原著>びまん性間質性肺疾患の気管支洗滌液中液性成分に関する研究

Abstract

Bronchoalveolar lavage fluid was analyzed for its liquid compnents following lavage performed in patients with sarcoidosis (Sar, 22cases), hypersensitivity pneumonitis (HP, 6), idiopathic interstitial pneumonitis (IIP, 9), interstitial pneumonitis with collagen vascular disease (CVD, 10), berylliosis (Be, 4), lung cancer (LC, 8), and healthy controls (7). Although albumin levels were markedly higher in Sar (10.2±1.7mg/dl) and HP (13.4±2.5mg/dl) than in the controls (3.3±0.5mg/dl), they were similar to control levels in IIP, CVD, Be, and LC. IgG/albumin was higher in Sar (0.33±0.03) and HP (0.49±0.19) than in the controls (0.16±0.01). In IIP, CVD and Be, it was markedly higher than in Sar or HP. IgA/albumin was higher in HP (0.21±0.06), IIP (0.16±0.03), CVD (0.22±0.05), and Be (0.20±0.08) than in the controls (0.07±0.02). IgM, which was not detected in the controls, was also negligible among the various diseases. ACE/albumin was lower in Sar (0.11±0.01) and HP (0.08±0.02) than in the controls (0.19±0.04). Lysozyme/albumin, lower than the corresponding serum value, was notably lower in HP (0.03±0.02) and in Sar (0.21±0.04) than in the controls (0.49±0.12). It was also slightly lower in IIP, CVD, and Be, but higher in LC (1.03±0.36) than in the controls. CEA (Z)/albumin was considerably higher in IIP (0.66±0.16), CVD (0.87±0.15), and Be (0.76±0.29), as well as in LC than in the controls. Immune Complex/albumin, similary to CEA (Z), was higher in IIP (1.21±0.30), CVD (0.72±0.43), Be (0.60±0.11), and LC (0.74±0.48) than in the controls (0.05±0.03). We classified diffuse interstitial pulmonary diseases into two groups based on the analysis of bronchoalveolar lavage fluid for cellular components : namely, T-lymphocyte alveolitis (Sar, HP, Be) and B-lymphocyte alveolitis (IIP, CVD). The present evaluation of the liquid components seems to justify a categorization of Sar and HP as one group and IIP and CVD as another.