摘要
目的探讨不同哮喘状态下网状基底膜厚度与气道壁结构变化的相关性。方法哮喘致死病例5例,哮喘患者死于非相关疾病5例,非哮喘死亡病例5例,取其肺组织,测量相当于纤维支气管镜活检能获取的软骨性气道(大气道)网状基底膜厚度,同时测量大、小气道(膜性气道)横断面的管壁结构,包括平滑肌面积、黏膜下腺体面积,气道内、外壁面积及气管内腔面积的变化,检验其相关性。结果大气道的网状基底膜厚度与平滑肌层面积(12.3μm±2.8μm、12.3μm±1.8μm vs3.5μm±1.2μm;12.7μm±1.9μm、12.3μm±2.9μm vs 4.2μm±0.4μm;r=0.721,P<0.05)、黏膜下腺体面积(r=0.644,P<0.05)、气道内壁面积(0.11 mm±0.03 mm、0.10 mm±0.02 mm vs 0.05mm±0.02 mm;0.27 mm±0.07 mm、0.14 mm±0.07 mm vs 0.08 mm±0.03 mmr=0.799,P<0.01)相关;与小气道的平滑肌面积(r=0.729,P<0.05)、气道内壁面积(r=0.865,P<0.01)相关;而与气管大小(周长)、内腔面积及气道外壁面积不相关。结论大气道的基底膜厚度变化可反映大气道重塑、小气道平滑肌层和气管内壁的改变。监测网状基底膜厚度的变化可用于评估哮喘的气道病理改变,及对哮喘病的长期追踪研究。
Objective To investigate the correlation between the reticular basement membrane thickness and the airway wall remolding in asthma patients. Methods Lung tissues were obtained from 5 patients who died from asthma, 3 males and 2 females, aged 45 ± 16 （fatal asthma group）, 5 asthmatics who died of diseases unrelated to asthma, 3 males and 2 females, aged 47 ±13, （non-fatal asthma group）, and 5 dead patients without asthma, 3 males and 2 females, aged 24 ± 14 （control group） to select 41, 38, and 43 transverse sections of tracheae respectively. The samples of tracheae were divided into cartilaginous and membranous airways by light microscopy （ × 100）. The thickness of reticular basement membrane and the dimensions of the airway wall, including the smooth muscle area, submucosal gland area, inner and outer wall areas, and lumen area were measured. The correlations of reticular basement membrane thickness with the airway changes were analyzed. Results The reticular basement membrane was significantly thicker in both cartilaginous and membranous airways in the fatal and non-fatal asthma groups than in the control group （ all P 〈 0.05 ）. The suhmucosal gland area of the fatal asthma group was significantly larger than those of the non-fatal asthma group and control group （ both P 〈 0. 05 ）. The inner wall area of the cartilaginous airway of the fatal asthma group was significantly larger than that of the non-fatal asthma group （P〈0.05） ; however, the inner wall area of the membranous airway of the fatal asthma group was not significantly different from that of the non-fatal asthma group. The outer wall areas of cartilaginous and membranous airways of the fatal asthma group were both significantly larger than those of the other 2 groups （all P 〈 0. 05 ）. There was no significant difference in the lumen areas of cartilaginous and membranous airways between the fatal and non-fatal asthma groups. The reticular basement membrane thickness was correlated with the smooth muscle area（ P 〈 0. 05）, submucosal gland area （P 〈 0. 05）, and inner wall area （P 〈0. 01 ） of the corresponding bronchi in regard to the cartilaginous airway; and was correlated with the smooth muscle area（P 〈 0.05 ） and inner wall area （P 〈 0.01 ） of the corresponding bronchi in regard to the membranous airway, but was not correlated with the airway size, lumen area, and outer wall area in regard tothe 2 kinds of airways. Conclusion The reticular basement membrane thickness of central airway reflects the airway remolding of the central airway and the changes of smooth muscle and inner wall of the peripheral airway. It is worthwhile to do end bronchial biopsy to measure the reticular basement membrane thickness so as to assess the pathology of the airway and to conduct long-term follow-up among the asthma patients.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2006年第7期468-471,共4页
National Medical Journal of China
关键词
哮喘
气道阻力
基底膜
Asthma
Basement membrane
Airway resistance
