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急性呼吸窘迫综合征中颈动脉体的形态学变化:一项人体形态计量学研究

Morphological changes of carotid bodies in acute respiratory distress syndrome: a morphometric study in humans.

作者信息

Vinhaes E N G, Dolhnikoff M, Saldiva P H N

机构信息

Departamento de Patologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.

出版信息

Braz J Med Biol Res. 2002 Oct;35(10):1119-25. doi: 10.1590/s0100-879x2002001000002. Epub 2002 Oct 13.

Abstract

Carotid bodies are chemoreceptors sensitive to a fall of partial oxygen pressure in blood (hypoxia). The morphological alterations of these organs in patients with chronic obstructive pulmonary disease (COPD) and in people living at high altitude are well known. However, it is not known whether the histological profile of human carotid bodies is changed in acute clinical conditions such as acute respiratory distress syndrome (ARDS). The objective of the present study was to perform a quantitative analysis of the histology of carotid bodies collected from patients who died of ARDS. A morphometric study of carotid bodies collected during routine autopsies was carried out on three groups: patients that died of non-respiratory diseases (controls, N = 8), patients that presented COPD and died of its complications or associated diseases (N = 7), and patients that died of ARDS (N = 7). Morphometric measurements of the volume fraction of clusters of chief cells were performed in five fields on each slide at 40X magnification. The numerical proportion of the four main histological cell types (light, dark, progenitor and sustentacular cells) was determined analyzing 10 fields on each slide at 400X magnification. The proportion of dark cells was 0.22 in ARDS patients, 0.12 in controls (P<0.001), and 0.08 in the COPD group. The proportion of light cells was 0.33 (ARDS), 0.44 (controls) (P<0.001), and 0.36 (COPD). These findings suggest that chronic and acute hypoxia have different effects on the histology of glomic tissue.

摘要

颈动脉体是对血液中氧分压下降(缺氧)敏感的化学感受器。慢性阻塞性肺疾病(COPD)患者以及生活在高海拔地区人群的这些器官的形态学改变是众所周知的。然而,尚不清楚在急性呼吸窘迫综合征(ARDS)等急性临床情况下,人类颈动脉体的组织学特征是否会发生变化。本研究的目的是对死于ARDS的患者的颈动脉体组织学进行定量分析。对三组在常规尸检期间收集的颈动脉体进行了形态计量学研究:死于非呼吸系统疾病的患者(对照组,N = 8)、患有COPD并死于其并发症或相关疾病的患者(N = 7)以及死于ARDS的患者(N = 7)。在每张载玻片上以40倍放大倍数在五个视野中对主细胞簇的体积分数进行形态计量测量。通过在每张载玻片上以400倍放大倍数分析10个视野来确定四种主要组织学细胞类型(亮细胞、暗细胞、祖细胞和支持细胞)的数量比例。ARDS患者中暗细胞的比例为0.22,对照组为0.12(P<0.001),COPD组为0.08。亮细胞的比例分别为0.33(ARDS)、0.44(对照组)(P<0.001)和0.36(COPD)。这些发现表明,慢性和急性缺氧对球旁组织的组织学有不同影响。

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