摘要
目的观察慢性阻塞性肺疾病(COPD)患者脏层胸膜的病理改变,以及该改变与COPD气流受限的关系。方法选取2014年5月—2015年8月于天津市胸科医院胸外科因肺部肿物,行全肺叶或部分肺叶切除手术患者70例。根据患者肺功能检查结果分为COPD组[第1秒用力呼气容积(FEV1)/用力肺活量(FVC)<70%,40例]与对照组(FEV1/FVC≥70%,30例)。对手术所获取肺组织进行取材(取材部位未被病变浸润,距离病变区域>2 cm)、制作组织切片,使用弹力纤维染色法(EVG)进行染色;显微镜下观察并计算2组脏层胸膜的厚度及弹力纤维所占比例。结果 COPD组标本取自肺上、中叶22例,肺下叶18例;对照组取自肺上、中叶17例,肺下叶13例;2组间标本获取部位差异无统计学意义(χ2=0.019,P>0.05)。COPD组脏层胸膜厚度及脏层胸膜中弹力纤维所占比例均小于对照组(均P<0.01)。2组内肺上、中叶脏层胸膜厚度均明显小于肺下叶(P<0.05),但肺上、中叶与肺下叶胸膜中弹力纤维所占比例差异无统计学意义。结论脏层胸膜变薄,弹力纤维减少是COPD患者呼气气流受限的原因之一。
Objective To observe the pathological change of visceral pleura in patients with chronic obstructivepulmonary disease（COPD）, and to discuss the relationship between the changes and COPD airflow limitation. Methods Atotal of 70 patients received the pulmonary lobectomy or partial resection because of lung tumor in Tianjin Chest Hospitalfrom May 2014 to August 2015 were selected in this study. According to the results of pulmonary function test, the patientswere divided into COPD group [forced expiratory volume in one second（FEV1）/ forced vital capacity（FVC） 〈70%,n=40]and control group（FEV1/FVC≥70%,n=30）. The lung tissues, which was not the lesion areas, were used to make tissuesections. The Elastica Van Gieson（EVG） method was used to stain the sections. The thickness of visceral pleural and theproportion of elastic fibers in visceral pleural were observed and calculated under a microscope in the two groups. Results The specimens were derived from upper and middle lobes in 22 cases of COPD group, and from lower lobe in 18 cases.Specimens were derived from upper and middle lobes in 17 cases of control group, and from lower lobe in 13 cases. Therewere no statistical differences in sampling sites between two groups（χ2=0.019,P〉0.05）. The visceral pleural thickness andthe proportion of elastic fibers in visceral pleural were significantly thinner in COPD group than those of control group（P 〈0.01）. In both COPD group and control group, visceral pleural thickness was significantly thinner in upper and middle lobesthan that of lower lobe（P 〈 0.05）, but the proportion of elastic fibers in visceral pleural of upper, middle lobes showed nostatistical difference compared with that of the lower lobe（P〉0.05）. Conclusion The thinner visceral pleural and thereduction of elastic fibers in visceral pleural are one of the causes of expiratory airflow limitation in COPD patients.
出处
《天津医药》
CAS
2017年第1期83-86,共4页
Tianjin Medical Journal
关键词
肺疾病
慢性阻塞性
胸膜
肺疾病
间质性
脏层胸膜
弹力纤维
肺弹性回缩力
呼气气流受限
pulmonary disease
chronic obstructive
pleura
lung diseases
interstitial
visceral pleura
elastic fiber
pulmonary elastic retraction force
expiratory airflow limitation
