Eidelman D, Saetta M P, Ghezzo H, Wang N S, Hoidal J R, King M, Cosio M G
Respiratory Division, Royal Victoria Hospital, Montreal, Quebec, Canada.
Am Rev Respir Dis. 1990 Jun;141(6):1547-52. doi: 10.1164/ajrccm/141.6.1547.
Inflammatory cells are believed to play an important role in the pathogenesis of emphysema; however, a relationship between presence of cells in the lung parenchyma and its destruction has never been shown. The aim of this study was to quantitate alveolar septal cellularity in smokers' lungs and to investigate its relationship with parenchymal destruction and lung function. The lungs of 23 smokers (SS) undergoing thoracotomy for localized pulmonary lesions were compared with those of eight nonsmokers (NS) and five smokers (AS) who died suddenly of nonrespiratory causes. Pulmonary function tests were performed within 1 wk of surgery in SS. For each subject, we quantitated alveolar wall cells (CELLS), an index of alveolar wall destruction (DI), and the mean linear intercept (Lm). As no significant differences were found between S and AS with regard to these indices, we combined them (Group S) for comparison with NS. Although Lm was not significantly different between S and NS, (0.331 +/- 0.072 versus 0.288 +/- 0.038), CELLS and DI were higher in S than in NS (48 +/- 8 versus 25 +/- 2 cells/mm, p less than 0.001; 47 +/- 20 versus 17 +/- 5, p less than 0.001, respectively). Further, CELLS and DI were significantly correlated (r = 0.799, p less than 0.001). The number of polymorphonuclear cells (PMN) in S can exceed that in NS by as much as 5-fold; however, PMN were inversely correlated with parenchymal destruction (DI) (r = 0.598, p less than 0.01). Thus, smokers' lungs have alveolar septal hypercellularity, possibly inflammatory, and closely related to destruction involving cells other than the PMN.
炎症细胞被认为在肺气肿的发病机制中起重要作用；然而，肺实质中细胞的存在与其破坏之间的关系从未得到证实。本研究的目的是定量吸烟者肺中的肺泡间隔细胞密度，并研究其与实质破坏和肺功能的关系。将23例因局限性肺部病变接受开胸手术的吸烟者（SS）的肺与8例非吸烟者（NS）和5例因非呼吸原因突然死亡的吸烟者（AS）的肺进行比较。SS组在手术1周内进行肺功能测试。对于每个受试者，我们定量了肺泡壁细胞（CELLS）、肺泡壁破坏指数（DI）和平均线性截距（Lm）。由于在这些指标方面S组和AS组之间未发现显著差异，我们将它们合并（S组）与NS组进行比较。尽管S组和NS组之间的Lm无显著差异（分别为0.331±0.072和0.288±0.038），但S组的CELLS和DI高于NS组（分别为48±8对25±2个细胞/mm，p<0.001；47±20对17±5，p<0.001）。此外，CELLS和DI显著相关（r = 0.799，p<0.001）。S组中的多形核细胞（PMN）数量可超过NS组多达5倍；然而，PMN与实质破坏（DI）呈负相关（r = 0.598，p<0.01）。因此，吸烟者的肺具有肺泡间隔细胞增多，可能是炎症性的，并且与除PMN之外的细胞破坏密切相关。
