??? ???? ????? ???? ???? ??

1
??? ???? ????? ???? ???? ??   ???, ???, ???,
???????? ???? ????????
? ?
????? ???(bronchoalveolar lavage BAL) ???
1970?? ?? ??? ???? ????? ???? ??? ??? ??? ????
??? ???? ???? ???. BAL? ???? ?? ??? ????? ?? ???
???? ?? ????? ????? ?? ??? ??? ??? ? ?? ??? ????
??. ?? ??? ??????? BAL ??? ???? ??? ?? ?? ???? ??
??? ??? ?? ???? ???? ??? ?? ??. ? ????? ?? ???
????? BAL? ???? ??? ???? ??? ??? ????? ???.

2. ??????? BAL? ???? ?? ??? 59 ???? ???? ??? ??
25 ?, ???? ??? ?? 25 ??? ??? 9 ?? ????????, ??
???? ??? ?? ???? ?? ??? ??? ???(Plt0.05)(Table 4).
Table 4. WBC differential counts in patients with
pulmonary tuberculosis Gruoup A) vs.
without pulmonary tuberculosis (Group B)
Group A Group B
Neutrophils 31 31 38 36
Lymphocytes 26 28 12 20 Plt0.05
Macrophages 42 32 41 33
Eosinophils 0.7 1.2 3.4 8.9 Plt0.05  
?? ? ??
1. ?? 1999? 3??? 2001? 3??? ????????? ??????
BAL ???? ??? ??? ? ? ???? ??? ??? 139 ?? ????
???. ?????? ??? ??? 59?, ?? ??? 46?, ??? ??? 13?
????, ? ? ???? ??? ?? ???? ??? 6?, ???? ???? ??
???? ??? 3?????, 2?? ??? ???, ??, ???? ??? ???
??? ???. ??? 34?? ???? ??????????(COPD), ??? ???
?? ???? ??? ? ??? ???? ??? ?? ?? ?? ?? ????
?????. 2. ?? BAL? ?? ?? ???? ???? ??? ?????.
??? BAL? ? ??? ? 50 uL? ??? 1,500 rpm?? 5??
cytospin? ? Wright-Giemsa ??? ?????. 1000 ? ????
200 ?? ??? ?? ????? ???? ? ??? ??? ? ?????. ???
90 ??? ??? ???? ?????, ???, ???? 10 ??? ??,
???? 5 ??? ?? ??? ??? ?????.
tjf
3. ?? ???? BAL? ???? ?? ??? 46 ???? ???? ??? ??
30 ?? ?? ???, ???? ??? ?? 14 ???? 1 ?? ????
?????, 1 ?? ?? ?????. ?? ?????? ??? ?? ???? ??
??? ??? ?? ?? ??? ???(Plt0.01)(Table 5). ?? ??? ??
??? ??? ??? 30? ??? ? ??? ? ???? ?? 67.4,
68.9??.  
Table 5. WBC differential counts in patients with
pneumonia (Group A) vs. without
pneumonia (Group B)
Group A Group B
Neutrophils 50 34 28 32 Plt0.01
Lymphocytes 21 25 20 24
Macrophages 27 24 48 34 Plt0.01
Eosinophils 1.4 4.7 2.6 7.7  
??
1. BAL ??? ???? ??   19?? ??? ?? ???
????(Table 1) ???? ??? ??? 64 ??? ??? 30 ?? ??
????(Table 2) ??? ??? ??? 47 ???? ??? 25 ?? ??
???(Table 3). 8 ??? ??? ??? ?????? ?????? 2 ? ???
???? 2 ? ???? ???. ??? ?? 1 ???? ?????? ?????.
? ?
BAL?? ??? ??? ?? ???? ?????, ??? ??? ?? ????
?????? ? ?? ?? BAL? ???? ??? ??? ??? ??? ??? ???
??? ? ?? ??? ????.
Table 1. Diseases showing normal BAL
pattern  (19 cases)
Pulmonary tuberculosis 9 cases
Cancer 3 cases
Others 6 cases
Containing 1 cases of pneumonia and
tuberculosiss Table 2. Diseases showing
neutrophil dominated BAL pattern (64 cases)
Pneumonia 30 cases
Pulmonary tuberculosis 22 cases
Cancer 1
cases Ohers
12 cases Containing 2 cases of
pneumonia and tuberculosis and 1 case of
pneumonia, tuberculosis and cancer
Containing 2 cases of tuberculosis
and cancer Table 3. Diseases showingh
lymphocyte dominated pattern (47 cases)
Pulmorany tuberculosis 25 cases
Pneumonia 10 cases
Cancer 3 cases
Others 9
cases Containing
3 cases of pneumonia and tuberculosis, 1 case of
pneumonia, tuberculosis and cances,
and 1 case of tuberculosis and
cancer
? ? ? ? 1. Milman N, Graudal N, Jacobsen GK.
Bronchoalveolar lavage in radiologically detected
diffuse lung disease. APMIS 1995103764-8. 2.
Ozaki T, Nakahira S, Tani K, Ogushi F, Yasuoka S,
Ogura T. Differential cell analysis in
bronchoalveolar lavage fluid from pulmonary
lesions of patients with tuberculosis. Chest
199210254-9. 3. Cobben NAM, Jacobs JA, van
Dieijen-Visser MP, Mulder PGH, Wouters EFM, Drent
M. Diagnostic value of BAL fluid cellular profile
and enzymes in infectious pulmonary disorders.
Eur Respir J 199914496-502. 4. Hoheise GB,
Tabak L, Teschler H, Erkan F, Kroegel C, Costabel
U. Bronchoalveolar lavage cytology and
immunocytology in pulmonary tuberculosis. Am J
Respir Crit Care med 1994149460-3.