Petty T L, Silvers G W, Stanford R E
Webb-Waring Lung Institute, University of Colorado Health Sciences Center, Denver 80262.
Am Rev Respir Dis. 1987 Oct;136(4):867-71. doi: 10.1164/ajrccm/136.4.867.
Thirty-nine excised human lungs were examined to identify early changes in the small airways, their size distribution, and their elastic recoil in relation to mild degrees of emphysema. Elastic recoil measurement, single-breath nitrogen (SBN2) tests, and FEV1 were obtained from 18 lungs with no emphysema and 21 emphysematous lungs with no greater than Grade 5 emphysema score. The mean number of alveolar attachments per brochiole was determined from all the bronchioles cut in cross section. When the 2 groups of lungs were compared, the percentage of predicted elastic recoil of the nonemphysematous lungs was significantly greater at 50, 70, 80, and 90% of TLC than in the mildly emphysematous lungs. The TLC of the emphysematous lungs (% of predicted) was also significantly greater than in the nonemphysematous lungs. Pigment of the small airways was the only pathologic feature that was significantly greater in the emphysematous lungs than in the nonemphysematous lungs. Size distribution in the small airways was similar except for the airways zero to 0.2 mm, which were more frequent in the emphysematous lungs. When data from both groups were combined, elastic recoil was shown to be related to both the number of alveolar attachments (p less than 0.03) and the mean diameter of the small airways (p less than 0.01). We conclude that structural and functional changes in lungs with mild emphysema include reduced elastic recoil, increased lung size, and some size distribution changes in the small airways. Mild emphysema is not associated with air-flow limitation.
对39个切除的人体肺部进行了检查，以确定小气道的早期变化、其大小分布以及与轻度肺气肿相关的弹性回缩情况。从18个无肺气肿的肺部和21个肺气肿评分不超过5级的肺气肿肺部获取了弹性回缩测量值、单次呼吸氮（SBN2）测试结果和第一秒用力呼气容积（FEV1）。通过对所有横切的细支气管确定每个细支气管的肺泡附着平均数。当比较这两组肺部时，非肺气肿肺部在肺总量（TLC）的50%、70%、80%和90%时预测弹性回缩的百分比显著高于轻度肺气肿肺部。肺气肿肺部的TLC（预测值的百分比）也显著高于非肺气肿肺部。小气道色素沉着是肺气肿肺部唯一比非肺气肿肺部显著更严重的病理特征。除了0至0.2毫米的气道在肺气肿肺部更常见外，小气道的大小分布相似。当将两组数据合并时，弹性回缩显示与肺泡附着数量（p小于0.03）和小气道平均直径（p小于0.01）均相关。我们得出结论，轻度肺气肿肺部的结构和功能变化包括弹性回缩降低、肺大小增加以及小气道的一些大小分布变化。轻度肺气肿与气流受限无关。
