结节病患者支气管肺泡灌洗液中CD+4/CD+8的分布研究

摘要

Objective To identify diagnostic significance of lymphocytes and the ratio of CD4+ to CD8+ ( CD4+ /CD8+ ratio ) in bronchoalveolar lavage fluid ( BALF ) in sarcoidosis.Methods Clinical parameters of 92 patients confirmed with sarcoidosis were tested, and the BAL was also evaluated in the first visit.Cell types and the ratio of CD4+ /CD8+ in BALF were tested.Results In these patients, the CD4/CD8 ratio ranged from 0.2 to 14.3 , with a median value of 3.3 ( mean 2.5 ).The CD4/ CD8 ratio was greater than 4 in only 20 ( 25％ ) patients.8 patients ( 10％ ) had a CD4/CD8 ratio less than 1.The distribution of CD4/CD8 ratios was similar to the increase or decrease of BAL lymphocytosis.Conclusion The CD4/CD8 ratio in bronchoalveolar lavage fluid is highly variable in biopsy - proven sarcoidosis.Bronchoalveolar lavage lymphocyte subset determination has low sensitivity for this disease.[%目的 为了明确支气管肺泡灌洗液(BALF)中淋巴细胞和CD+4/CD+8比值在肺结节病中的诊断意义.方法 选取92例经病理诊断的结节病患者,评估其临床参数,并把支气管肺泡灌洗(BAL)作为初诊评估的一部分,检测BALF中细胞类型及淋巴细胞亚群CD+4/CD+8比值.结果 对于本研究的结节病患者,CD+4/CD+8比值范围为0.2～14.3,中位值3.3(均值2.5).仅有20例(25%)结节病患者CD+4/CD+8比值＞4,8例患者(10%)CD+4/CD+8比值＜1,淋巴细胞增加或减少和CD+4/CD+8比值分布相似.结论 经病理确诊的结节病患者BALF中CD+4/CD+8比值分布具有高度变异性.BALF中淋巴细胞亚群对于结节病的诊断敏感性较低.