[Cell profiles of bronchoalveolar lavage fluid as prognostic indicators of idiopathic pulmonary fibrosis].
OBJECTIVE
To determine whether clinical and physiologic variables and bronchoalveolar lavage fluid (BALF) cell profiles affect the survival of patients with idiopathic pulmonary fibrosis (IPF).


METHODS
There were 43 patients with clinically diagnosed IPF in the study. The Kaplan-Meier method and the Log-rank test were used to estimate the survival in the two groups and Cox proportional hazard regression was used to evaluate the Hazard Ratio in the IPF patients.


RESULTS
The IPF patients presented with restrictive ventilatory disorders [FVC%: (61 +/- 18)%, TLC%: (54 +/- 13)%] and gas exchange impairment [D(L)CO%: (48 +/- 14)%]. The mean follow-up time was 30.7 months, and the median survival of IPF patients was 28.5 months after diagnosis. FVC ( Wald = 6.71, P < 0.01), TLC ( Wald = 12.37, P < 0.01) , D(L)CO ( Wald = 22.78, P < 0.01), neutrophil ( Wald = 16.26, P < 0.01) and eosinophil ( Wald = 7.73, P < 0.01) percentages were prognostic variables in the univariate Cox proportional hazard regression, and only D(L)CO (HR = 0.93, Wald = 15.77, P < 0.01) and the neutrophil percentage (HR = 1.07, Wald = 6.83, P < 0.01) were prognostic variables for IPF patients in the multivariate Cox proportional hazard regression.


CONCLUSIONS
The IPF patients were predominantly old males and presented with restrictive ventilatory disorders and gas exchange impairment. Glucocorticoids and/or cytotoxic drugs could not improve the prognosis for the IPF patients. DLCO and BALF neutrophil percentage were prognostic variables, and DLCO was negatively correlated with the prognosis while the neutrophil percentage was positively correlated with the prognosis in the IPF patients.
Institute of Respiratory Disease, First Affiliated Hospital, China Medical University, Shenyang 110001, China.
Shou-chun
SC
Peng
Zhen-hua
ZH
Li
Jian
J
Kang
Xian-ming
XM
Hou
Run-jiang
RJ
Yu
D000368:Aged; D001992:Bronchoalveolar Lavage Fluid / Q000166:cytology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D054990:Idiopathic Pulmonary Fibrosis / Q000175:diagnosis* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012129:Respiratory Function Tests; D015996:Survival Rate