Scott A, Wang X, Road J D, Reid W D
School of Rehabilitation Sciences, University of British Columbia, Vancouver, Canada.
Eur Respir J. 2006 Jan;27(1):51-9. doi: 10.1183/09031936.06.00143004.
Evidence for diaphragm injury in people with chronic obstructive pulmonary disease (COPD) has been reported, although the extent of injury and collagen accumulation post mortem have not previously been examined. In addition, it is not known whether the amount of injury and collagen are different in key regions of the diaphragm. The cross-sectional area of collagen and the percentage of abnormal myofibres in the post mortem diaphragm and psoas major were determined by computer-assisted image analysis of stained cross-sections of the diaphragm for collagen with picrosirius red and with haematoxylin and eosin for morphology. In the midcostal diaphragm of six subjects with COPD and six subjects with no significant respiratory disease, the COPD diaphragm displayed a greater cross-sectional area of collagen and percentage of abnormal myofibres (collagen: 24.2+/-1.0 versus 18.6+/-1.1%; injury: 28.4+/-7.2 versus 12.0+/-1.3%). In 18 patients with various respiratory conditions, the midcostal diaphragm displayed more collagen and abnormal myofibres than the crural diaphragm, while both costal and crural diaphragms displaying more collagen and abnormal myofibres than psoas major. This study reveals extensive injury and collagen accumulation in the chronic obstructive pulmonary diseased diaphragm, and reveals a regional pattern of injury and intramuscular collagen which may correspond to variations in diaphragm loading.
已有报道称慢性阻塞性肺疾病（COPD）患者存在膈肌损伤，不过此前尚未对死后膈肌损伤程度及胶原蛋白积累情况进行研究。此外，尚不清楚膈肌关键区域的损伤量和胶原蛋白含量是否存在差异。通过对膈肌染色横断面进行计算机辅助图像分析，使用丽春红对胶原蛋白进行染色，苏木精和伊红对形态进行染色，测定死后膈肌和腰大肌的胶原蛋白横截面积及异常肌纤维百分比。在6名COPD患者和6名无明显呼吸系统疾病患者的肋膈中，COPD患者的膈肌显示出更大的胶原蛋白横截面积和异常肌纤维百分比（胶原蛋白：24.2±1.0%对18.6±1.1%；损伤：28.4±7.2%对12.0±1.3%）。在18名患有各种呼吸疾病的患者中，肋膈的胶原蛋白和异常肌纤维比膈脚更多，而肋膈和膈脚的胶原蛋白和异常肌纤维均比腰大肌更多。本研究揭示了慢性阻塞性肺疾病患者膈肌存在广泛损伤和胶原蛋白积累，并揭示了损伤和肌内胶原蛋白的区域模式，这可能与膈肌负荷的变化相对应。
