Yamada Gen, Takahashi Hiroki, Shijubo Noriharu, Itoh Takayuki, Abe Shosaku
Third Department of Internal Medicine, Sapporo Medical University, School of Medicine, Chuo-ku South 1 West 16, Sapporo, 060-8543 Japan.
Chest. 2005 Aug;128(2):876-80. doi: 10.1378/chest.128.2.876.
The bronchial vasculature serves important functions and is modified in a variety of pulmonary and airway diseases. The remarkable ability of the bronchial vasculature to undergo remodeling has implications for disease pathogenesis. However, there is very little information on normal bronchial circulation.
The aim of this study was to obtain information on bronchial microvessels in large airways using a high-magnification bronchovideoscope.
Recently, we developed a high-magnification bronchovideoscope (XBF-200HM3 [side-viewing type]) in cooperation with Olympus Medical Systems. This bronchovideoscope can provide information on the bronchial mucosa with a maximum magnification of 110 times. Between August 2000 and July 2004, 26 patients without abnormalities in the large airways were enrolled into this study. Patients underwent conventional bronchoscopy and subsequent bronchoscopy with the high-magnification bronchovideoscope. After the bronchoscopic examination, we calculated the vessel area ratios and hemoglobin indexes of images made with the high-magnification bronchovideoscope by using appropriate software. In addition, we compared the findings obtained with the high-magnification bronchovideoscope of the 26 subjects with microscopic findings of autopsied tracheas of two patients without abnormalities.
Many ramifying subepithelial microvessels of large airways were mainly observed in intercartilage and membranous portions, whereas only a few microvessels were seen in cartilage portions. Histologically, these subepithelial microvessels were thought to be distributed within approximately 800 and 500 microm beneath the surface of the intercartilage portions and membranous portions, respectively. Vessel area ratios of the intercartilage portions were significantly higher than those of the cartilage and membranous portions. The hemoglobin indexes of the intercartilage portions were significantly higher than those of the cartilage and membranous portions, and these indexes were also significantly higher in the membranous portion than in the cartilage portion.
A dense concentration of subepithelial microvessels was mainly observed in the intercartilage portion, indicating an increase in submucosal circulation. This high-magnification bronchovideoscope is a useful tool for observing and evaluating the subepithelial microvessels in large airways.
支气管血管系统具有重要功能，且在多种肺部和气道疾病中会发生改变。支气管血管系统显著的重塑能力对疾病发病机制具有重要意义。然而，关于正常支气管循环的信息非常少。
本研究旨在使用高倍支气管电子内镜获取大气道支气管微血管的相关信息。
最近，我们与奥林巴斯医疗系统合作开发了一种高倍支气管电子内镜（XBF - 200HM3[侧视型]）。这种支气管电子内镜能够提供最大放大倍数为110倍的支气管黏膜信息。在2000年8月至2004年7月期间，26例大气道无异常的患者纳入本研究。患者先接受常规支气管镜检查，随后使用高倍支气管电子内镜进行检查。支气管镜检查后，我们使用适当软件计算高倍支气管电子内镜所拍摄图像的血管面积比和血红蛋白指数。此外，我们将26例受试者高倍支气管电子内镜检查结果与2例无异常的尸检气管的显微镜检查结果进行了比较。
大气道许多分支状的上皮下微血管主要见于软骨间部和膜部，而软骨部微血管较少。组织学上，这些上皮下微血管分别被认为分布在软骨间部和膜部表面以下约800微米和500微米范围内。软骨间部的血管面积比显著高于软骨部和膜部。软骨间部的血红蛋白指数显著高于软骨部和膜部，且膜部的这些指数也显著高于软骨部。
上皮下微血管主要密集分布于软骨间部，提示黏膜下循环增加。这种高倍支气管电子内镜是观察和评估大气道上皮下微血管的有用工具。
