Eidelman D H, Bellofiore S, Chiche D, Cosio M G, Martin J G
Meakins-Christie Laboratories, McGill University, Montreal, Canada.
Lung. 1990;168(3):159-69. doi: 10.1007/BF02719687.
Two morphometric indices, the destructive index (DI), a measure of alveolar wall destruction, and the proportion of destroyed alveolar attachments to the airways (AA), have been proposed as measures of early lung destruction in human smokers. The aim of this study was to compare DI and AA to the usual measure of airspace enlargement--the mean linear intercept (Lm)--in experimental emphysema. Porcine pancreatic elastase was administered intratracheally to 2 groups of Brown Norway rats (high-dose, n = 8, 1 IU/g body weight; low-dose, n = 4, 0.7 IU/g; control, n = 7). Total lung capacity (TLC), functional residual capacity (FRC) and pressure-volume curves were measured 3 weeks after administration of elastase. Lung elasticity was assessed by chord compliance (Cst). Administration of high-dose, but not low-dose, elastase led to significant increases in FRC and TLC. Cst significantly increased after high-dose elastase compared to controls (p less than 0.01). Lm increased after both low-dose and high-dose elastase compared to controls (p less than 0.01); DI and AA were increased only after high-dose elastase. Significant correlations were found between each morphometric index and Cst; the highest correlation was with AA. Behavior of the morphometric indices in this model differed from that reported in human smokers: Lm was a more sensitive measure of destruction than DI, reflecting a process marked by predominance of airspace enlargement over alveolar septal breaks. These differences from human smokers may result from a differing underlying pathogenesis of lung destruction.
已提出两种形态测量指标，即破坏指数（DI），用于衡量肺泡壁破坏程度，以及气道破坏肺泡附着比例（AA），作为人类吸烟者早期肺破坏的测量指标。本研究的目的是在实验性肺气肿中比较DI和AA与通常的气腔扩大测量指标——平均线性截距（Lm）。将猪胰弹性蛋白酶经气管内给予2组棕色挪威大鼠（高剂量组，n = 8，1 IU/g体重；低剂量组，n = 4，0.7 IU/g；对照组，n = 7）。在给予弹性蛋白酶3周后测量总肺容量（TLC）、功能残气量（FRC）和压力-容积曲线。通过弦顺应性（Cst）评估肺弹性。高剂量而非低剂量的弹性蛋白酶给药导致FRC和TLC显著增加。与对照组相比，高剂量弹性蛋白酶给药后Cst显著增加（p < 0.01）。与对照组相比，低剂量和高剂量弹性蛋白酶给药后Lm均增加（p < 0.01）；仅高剂量弹性蛋白酶给药后DI和AA增加。在每个形态测量指标与Cst之间发现显著相关性；与AA的相关性最高。该模型中形态测量指标的行为与人类吸烟者报告的不同：Lm是比DI更敏感的破坏测量指标，反映了一个以气腔扩大超过肺泡间隔破裂为主导的过程。与人类吸烟者的这些差异可能源于肺破坏的潜在发病机制不同。
