【摘要】 目的 研究肺炎病儿肺泡灌洗液中肺泡表面活性物质(PS)的变化，探讨PS在肺炎发病中的作用。方法 选择肺炎病儿20例(肺炎组)和非肺炎病儿20例(对照组)，应用纤维支气管镜进行肺泡灌洗，收集肺泡灌洗液，分别采用Bartlett法检测肺泡灌洗液中总磷脂(TPL)、Mason法检测饱和磷脂酰胆碱(SatPC)、焦酚红染色法(Pyrogallol)检测总蛋白(TP)。以SatPC/TPL和SatPC/TP比值作为判断PS活性水平的指标。结果 肺炎组SatPC虽然较低，但与对照组比较差异无统计学意义(t=1.062，P>0.05);肺炎组SatPC/TPL和SatPC/TP较对照组明显降低，差异有显著统计学意义(t=5.383、3.938，P<0.001)。结论 肺炎病儿肺泡灌洗液中PS降低，可能是导致肺炎反复或迁延不愈的重要原因之一，PS替代疗法是肺炎的一种有效的辅助治疗手段。
【关键词】 肺表面活性物质相关蛋白质类;支气管肺泡灌洗液;肺炎;儿童
CHANGES OF PS LEVEL IN BRONCHOALVEOLAR LAVAGE FLUID IN CHILDREN WITH PNEUMONIA ZHANG SHAOFEN, DENG JIKUI, LI JING, et al (Department of Respirotory, Shenzhen Children’s Hospital, Shenzhen 518026, China); [ABSTRACT] Objective To study the changes of the level of pulmonary surfactant (PS) in bronchoalveolar lavage fluid in children with pneumonia and the role of PS in pathogenesis of the disease. Methods Twenty patients with pneumonia and 20 with nonpneumonia were enrolled and alveolar wash (AS) was done via bronchofibroscopy and lavage fluid collected. Total phospholipids (TPL) was detected by Bartlett method; saturated phosphatidylcholine (SatPC) by Manson method; and total protein (TP) by Pyrogallol. The ratio of SatPC/TPL to SatPC/TP was taken as a parameter to estimate the activity of PS. ResultsCompared with the nonpneumonia, the amount of SatPC in the pneumonia was lower, but the difference between them was not significant (t=1.062,P>0.05). The ratio of SatPC/TPL to SatPC/TP in the pneumonia was significantly lower than that in the nonpneumonia (t=5.383,3.938;P<0.001). Conclusion Decrease of PS content in bronchoalveolar lavage fluid in children with pneumonia may be one of important factors contributing recurrance or protraction of the disease. PSsubstitution is an effective therapy for pneumonia.
[KEY WORDS] Pulmonary surfactantassociated proteins; Bronchoalveolar lavage fluid; Pneumonia; Child
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