抄録
Two kinds of lavage for broncho-alveolar system were performed in 8 normal volunteers. In broncho-alveolar lavage (BAL), a segment (B4 or B5) was lavaged with 50ml of saline 3 times. In bronchial lavage (BL), we inserted a flexible bronchofiberscope into the lower lobe bronchus and infused 25ml of saline into the bronchus without wedging the tip of the bronchofiberscope. Then we aspirated the infused saline. This procedure was repeated 3 times.
Percentage recovery of infused saline in BAL and BL were 65±6 and 30±6%, respectively. Bronchial lavage fluid (BLF) was more turbid than the broncho-alveolar lavage fluid (BALF), and a clear mucus layer was found on top. We compared the cellular components, protein components, and fucose and sialic acid contents of BLF with those of BALF. We measured fucose and sialic acid to evaluate the mucus content.
Both BLF and BALF contained alveolar macrophages, but in differential cell counts the percentage of neutrophils and epithelial cells were higher in BLF than in the BALF. BLF contained much more mucus, IgA, S-IgA and lysozyme than the BALF.
These results indicate that BLF contains many bronchial components besides alveolar components, and that the compositions of cellular and protein components change from the proximal bronchus to the alveolar region.
BLF from 4 patients with chronic bronchitis contained significantly more neutrophils, protein components, and fucose and sialic acid than that from normal volunteers. This result indicates that the present BL technique is useful for quantitative analysis of bronchial components to clarify the pathophysiology of chronic airway disease.
