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Abstract：
UNASSIGNED: Bronchoalveolar lavage (BAL) is a useful tool in the diagnostic work-up of patients with interstitial lung diseases (ILDs). In this prospective study, we investigated the clinical usefulness of BAL in patients with ILD radiographically.
UNASSIGNED: The enrolled patients were classified into outpatient department (OPD), and inpatients groups who was admitted to general ward (GW) or intensive care unit (ICU) groups based on the time when BAL done. The clinical usefulness of BAL was defined as a new diagnosis established and/or treatment significantly changed. The clinical usefulness of BAL among the three groups of patients and the patients divided by underlying diseases was compared using the χ2 test with or without Fisher\'s exact test.
UNASSIGNED: Among our 184 patients, there were 37 in OPD group, 86 in GW group and 61 in ICU group. The final diagnoses were infectious in 23, non-infectious in 102, mixed etiologies in 19, and non-diagnostic in 40 patients. The diagnostic yields (revised diagnosis after BAL) of BAL among ICU patients, GW patients and OPD patients were 60.6%, 69.7% and 21.6%, respectively (P<0.001), and was 57.1% in total patients. The diagnostic yields of BAL among patients with cancer, organ transplantation and collagen vascular disease were statistically different (P=0.009).
UNASSIGNED: BAL is of use in establishing a diagnosis of ILD and is mandatary especially in the admitted patients with ILD because diagnostic yield was relatively higher in admitted patients than in OPD patients. In addition, BAL should be done more early in the admitted patients with malignancy, stem cell and/or organ transplantation and collagen vascular disease especially when they showed poor response to initial medications.
UNASSIGNED: The enrolled patients were classified into outpatient department (OPD), and inpatients groups who was admitted to general ward (GW) or intensive care unit (ICU) groups based on the time when BAL done. The clinical usefulness of BAL was defined as a new diagnosis established and/or treatment significantly changed. The clinical usefulness of BAL among the three groups of patients and the patients divided by underlying diseases was compared using the χ2 test with or without Fisher\'s exact test.
UNASSIGNED: Among our 184 patients, there were 37 in OPD group, 86 in GW group and 61 in ICU group. The final diagnoses were infectious in 23, non-infectious in 102, mixed etiologies in 19, and non-diagnostic in 40 patients. The diagnostic yields (revised diagnosis after BAL) of BAL among ICU patients, GW patients and OPD patients were 60.6%, 69.7% and 21.6%, respectively (P<0.001), and was 57.1% in total patients. The diagnostic yields of BAL among patients with cancer, organ transplantation and collagen vascular disease were statistically different (P=0.009).
UNASSIGNED: BAL is of use in establishing a diagnosis of ILD and is mandatary especially in the admitted patients with ILD because diagnostic yield was relatively higher in admitted patients than in OPD patients. In addition, BAL should be done more early in the admitted patients with malignancy, stem cell and/or organ transplantation and collagen vascular disease especially when they showed poor response to initial medications.
摘要：
■支气管肺泡灌洗（BAL）是诊断间质性肺病（ILD）患者的有用工具。在这项前瞻性研究中，我们调查了BAL对ILD患者的临床应用价值。
■纳入的患者被归类为门诊部（OPD），以及根据BAL完成时间进入普通病房（GW）或重症监护病房（ICU）组的住院患者组。BAL的临床有用性被定义为新诊断确立和/或医治显著变更。使用有或没有Fisher精确检验的χ2检验比较三组患者和按基础疾病划分的患者中BAL的临床有效性。
■在我们的184名患者中，OPD组有37人,86GW组和ICU组61。最终诊断为感染23例，非感染102例，混合病因19例，非诊断性40例。ICU患者中BAL的诊断率（BAL后的修订诊断），GW患者和OPD患者为60.6%，69.7%和21.6%，分别为(P<0.001)，占总患者的57.1%。BAL在癌症患者中的诊断率，器官移植和胶原血管性疾病有统计学差异(P=0.009)。
■BAL可用于建立ILD的诊断，尤其是在入院的ILD患者中，这是强制性的，因为入院患者的诊断率相对高于OPD患者。此外,入院的恶性肿瘤患者应更早进行BAL，干细胞和/或器官移植和胶原血管疾病，特别是当它们对初始药物反应较差时。
■纳入的患者被归类为门诊部（OPD），以及根据BAL完成时间进入普通病房（GW）或重症监护病房（ICU）组的住院患者组。BAL的临床有用性被定义为新诊断确立和/或医治显著变更。使用有或没有Fisher精确检验的χ2检验比较三组患者和按基础疾病划分的患者中BAL的临床有效性。
■在我们的184名患者中，OPD组有37人,86GW组和ICU组61。最终诊断为感染23例，非感染102例，混合病因19例，非诊断性40例。ICU患者中BAL的诊断率（BAL后的修订诊断），GW患者和OPD患者为60.6%，69.7%和21.6%，分别为(P<0.001)，占总患者的57.1%。BAL在癌症患者中的诊断率，器官移植和胶原血管性疾病有统计学差异(P=0.009)。
■BAL可用于建立ILD的诊断，尤其是在入院的ILD患者中，这是强制性的，因为入院患者的诊断率相对高于OPD患者。此外,入院的恶性肿瘤患者应更早进行BAL，干细胞和/或器官移植和胶原血管疾病，特别是当它们对初始药物反应较差时。
