镰状细胞病急性胸部综合征期间金黄色气管分泌物和支气管肺泡灌洗液
Golden tracheal secretions and bronchoalveolar fluid during acute chest syndrome in sickle cell disease.
作者信息
Contou Damien, Mekontso Dessap Armand, Carteaux Guillaume, Brun-Buisson Christian, Maitre Bernard, de Prost Nicolas
机构信息
Service de Réanimation Médicale, Cardiovascular and Respiratory Manifestations of Acute Lung Injury and Sepsis (CARMAS) Research Group, Groupe Henri Mondor-Albert Chenevier, Assistance Publique Hôpitaux de Paris and Université Paris-Est Créteil Val de Marne, Créteil, France. Institut National de la Santé et de la Recherche Médicale, Unité U955, Créteil, France.
Service de Réanimation Médicale, Cardiovascular and Respiratory Manifestations of Acute Lung Injury and Sepsis (CARMAS) Research Group, Groupe Henri Mondor-Albert Chenevier, Assistance Publique Hôpitaux de Paris and Université Paris-Est Créteil Val de Marne, Créteil, France.
出版信息
Respir Care. 2015 Apr;60(4):e73-5. doi: 10.4187/respcare.03517. Epub 2014 Oct 14.
Acute chest syndrome (ACS) is the leading cause of ICU admission in patients with sickle cell disease and is characterized by golden sputum, which is commonly attributed to the presence of bilirubin. Three young consecutive patients with homozygous sickle cell disease were admitted for severe acute respiratory syndrome due to ACS. In all 3 patients, tracheal secretions and bronchoalveolar lavage fluid (BALF) showed a yellowish plasma-like stain. After normalization for the plasma-to-BAL urea ratio, BALF protein and lactate dehydrogenase levels were consistent with an exudative process. BALF bilirubin concentrations were very low, implying that the yellowish stain was not related to bilirubin content. The yellowish coloration of tracheal secretions and BALF observed during ACS appears to be related to an intense exudative process rather than to the presence of bilirubin.
急性胸综合征（ACS）是镰状细胞病患者入住重症监护病房（ICU）的主要原因，其特征为痰液呈金黄色，这通常归因于胆红素的存在。三名连续的年轻纯合镰状细胞病患者因ACS导致的严重急性呼吸综合征入院。在所有3例患者中，气管分泌物和支气管肺泡灌洗液（BALF）均呈现淡黄色血浆样染色。在对血浆与BAL尿素比值进行标准化后，BALF蛋白和乳酸脱氢酶水平与渗出过程一致。BALF胆红素浓度非常低，这表明淡黄色染色与胆红素含量无关。在ACS期间观察到的气管分泌物和BALF的淡黄色似乎与强烈的渗出过程有关，而非与胆红素的存在有关。
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