肺部感染儿童支气管肺泡灌洗液病原及细胞学分析

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摘要目的分析肺部感染儿童支气管肺泡灌洗液（BALF）中的病原及细胞学成分，为临床提供诊断及治疗依据。方法选取2021年8月至2022年10月于泉州市儿童医院住院治疗的42例患儿作为研究对象，其中23例BALF培养确诊为细菌感染性肺炎的患儿为细菌性肺炎组，19例支气管异物行异物取出术后BALF培养无细菌生长的患儿为支气管异物组。采用液基细胞学沉降法对上述两组患儿BALF进行病理学分析。结果 23例细菌性肺炎以肺炎链球菌感染为主，肺部CT易合并肺不张；19例支气管异物以左主支气管异物多见，其中以坚果类异物为主。细菌性肺炎组的中性粒细胞百分比、C反应蛋白（CRP）水平高于支气管异物组，差异有统计学意义（P＜0.05）；细菌性肺炎组的淋巴细胞百分比低于支气管异物组，差异有统计学意义（P＜0.05）；细菌性肺炎组BALF中性粒细胞百分比高于支气管异物组，差异有统计学意义（P＜0.05）；两组BALF中淋巴细胞百分比、巨噬细胞百分比、纤毛柱状上皮细胞百分比比较，差异无统计学意义（P＞0.05）。结论儿童细菌性肺炎以肺炎链球菌感染多见，其BALF细胞学组成以中性粒细胞为主，这为临床诊断及治疗提供了依据，避免临床抗生素滥用。

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	尤玉婷曾丽娥林春燕陈琼华林洁如郑敬阳

关键词 ：细菌性肺炎, 支气管肺泡灌洗液, 细胞学分析, 儿童

Abstract：Objective To analyze the pathogenic and cytological components of bronchoalveolar lavage fluid (BALF) in children with pulmonary infection and to provide evidence for clinical diagnosis and treatment. Methods A total of 42 children hospitalized in Quanzhou Children's Hospital from August 2021 to October 2022 were selected as the research objects. Among them, 23 children diagnosed with bacterial pneumonia by BALF culture were in the bacterial pneumonia group, and 19 children without bacterial growth cultured by BALF after foreign body removal were in the bronchial foreign body group. The pathological analysis of BALF in the two groups was carried out by cytological sedimentation method. Results The main bacterial pneumonia in 23 cases was Streptococcus pneumoniae infection, lung CT was easy to be complicated with atelectasis. The most common bronchial foreign bodies in 19 cases were in the left main bronchus, and nut foreign bodies were the main ones. The percentage of neutrophil and C-reactive protein (CRP) in bacterial pneumonia group were higher than those in bronchial foreign body group, and the differences were statistically significant (P＞0.05). The percentage of lymphocyte in bacterial pneumonia group was lower than that in bronchial foreign body group, the difference was statistically significant (P＞0.05). The percentage of neutrophils in BALF in bacterial pneumonia group was higher than that in bronchial foreign body group, and the difference was statistically significant (P＜0.05). There were no significant differences in the percentage of lymphocytes, macrophages and ciliary columnar epithelial cells in BALF between the two groups (P＞0.05). Conclusion Streptococcus pneumoniae is the most common bacterial pneumonia in children, and the cytological composition of BALF is mainly neutrophils, which provides a basis for clinical diagnosis and treatment, and avoids clinical antibiotic abuse.

Key words： Bacterial pneumonia Bronchoalveolar lavage fluid Cytological analysis Child

基金资助:[基金项目]福建省泉州市医疗卫生领域指导性科技计划项目（2021N091S）。

通讯作者: 郑敬阳（1969-），男，汉族，福建泉州人，硕士，主任医师；研究方向：儿童呼吸。

作者简介: 尤玉婷（1987-），女，汉族，福建泉州人，硕士；研究方向：儿童呼吸。

引用本文:

尤玉婷曾丽娥林春燕陈琼华林洁如郑敬阳. 肺部感染儿童支气管肺泡灌洗液病原及细胞学分析[J]. 中国当代医药, 2024, 31(1): 64-67.
YOU Yuting ZENG Li′e LIN Chunyan CHEN Qionghua LIN Jieru ZHENG Jinyang. Etiology and cytological analysis of bronchoalveolar lavage fluid in children with pulmonary infection. 中国当代医药, 2024, 31(1): 64-67.

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https://www.dangdaiyiyao.com/CN/ 或 https://www.dangdaiyiyao.com/CN/Y2024/V31/I1/64

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