Aikawa T, Shimura S, Sasaki H, Takishima T, Yaegashi H, Takahashi T
First Department of Internal Medicine, Tohoku University School of Medicine, Sendai, Japan.
Am Rev Respir Dis. 1989 Aug;140(2):477-82. doi: 10.1164/ajrccm/140.2.477.
Mucus volume in both central and peripheral airways was assessed in 13 patients, six with chronic bronchitis (CB) and seven with chronic pulmonary emphysema (CPE), by morphologic quantitative measurement in autopsied lungs, and the results were compared with those from four control lungs (NL). The patients with CB and CPE had severe obstructive impairment that did not differ significantly between the two groups (FEV1%, mean 45% in CB and mean 49% in CPE). Mucous hypersecretion during clinical remission differed significantly between the CB and CPE groups (mean 80 ml/day in CB and mean 8 ml/day in CPE). The length of the airway basement membrane and the area of mucus were measured with a digitizing computer. The volume ratio of mucus to airway lumen, which was defined as the volume ratio of mucus to airway lumen calculated as a cylinder by the length of basement membrane, was regarded as the mucus occupying ratio (MOR). MOR was significantly higher in CB lungs (4.1 +/- 1.0% in central airways and 19.6 +/- 3.8% in peripheral airways, mean +/- SE) than in NL (0.3 +/- 0.1% in central airways and 0.6 +/- 0.3% in peripheral airways, respectively) in both central and peripheral airways (p less than 0.05 and p less than 0.01, respectively), whereas no significant increase in MOR was found in CPE lungs, compared with NL. Furthermore, peripheral airway MOR was significantly higher than that of central airways in CB lungs (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
通过对13例患者(6例慢性支气管炎(CB)患者和7例慢性肺气肿(CPE)患者)尸检肺组织进行形态学定量测量,评估了中央气道和外周气道的黏液量,并将结果与4例对照肺(NL)的结果进行比较。CB和CPE患者均有严重的阻塞性损害,两组之间无显著差异(FEV1%,CB组平均为45%,CPE组平均为49%)。CB组和CPE组临床缓解期的黏液分泌过多情况有显著差异(CB组平均80 ml/天,CPE组平均8 ml/天)。使用数字化计算机测量气道基底膜长度和黏液面积。黏液与气道路腔的体积比定义为以基底膜长度按圆柱体计算的黏液与气道路腔的体积比,被视为黏液占据率(MOR)。CB组肺组织的MOR在中央气道(4.1±1.0%)和外周气道(19.6±3.8%,平均值±标准误)均显著高于NL组(中央气道分别为0.3±0.1%,外周气道为0.6±0.3%)(p分别小于0.05和p小于0.01),而与NL组相比,CPE组肺组织的MOR无显著增加。此外,CB组肺组织外周气道的MOR显著高于中央气道(p小于0.05)。(摘要截断于250字)