CHANGE OF BRONCHOALVEOLAR LAVAGE FLUID AND PATHOLOGY IN ACUTE ASPIRATION PNEUMONIA BY DUODENOGASTROESOPHAGEAL REFLUX

Wang Q¹, Zheng SM², Xu GX¹, Cui L², Li J¹, Han GW¹

¹ Hospital of Harbin Branch of Railway, Harbin, China

² Northeast Agricultural University, Harbin, China

Objective: To understand the change of pathophysiology in aspiration pneumonia by duodenogastroesophageal reflux (DGER).

Methods: Injected gestric fluid and bile into the trachea of the young rabbits in experiment group (n=20). Tested the bronchoalveolar lavage fluid (BALF), observed the pathological tissue of the lung, and compareed it with control group (n=5) after 2,8,24,72h.

Results: 1.The cell count in BALF increase (P<0.05), the differential count are both, the megakaryocyte and the neutrophil in majority, the highest peak of the neutrophil at 8h (53%). 2.The total protein in BALF increase too (P<0.01). 3. The tunmor necrosis factor (TNF) and the interleukin-8 (IL-8) in BALF increase obviously by radioimmunoassay (P<0.001), the peak of it at 24h. 4. The lung body index (LBI) increase (P<0.05). 5. The inflammatory cells invade the pulmonary alveolus, the red blood cell collect in capillary by the light microscopy. 6. The lamellar body decreases and the mitochondria swell in type II alveolar cells by scanning electron microscopy (SEM).

Conclusion: The gestric fluid and the bile are both attack factors in DGER. It can cause the inflammatory cells and inflammatory mediators to increase in the pulmonary alveolus. The alveoli epithelia degenerate and necrose. It can result in pulmonary edema and acute lung injury (ALI).

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