Cosio M G, Shiner R J, Saetta M, Wang N S, King M, Ghezzo H, Angus E
Am Rev Respir Dis. 1986 Jan;133(1):126-31. doi: 10.1164/arrd.1986.133.1.126.
We studied 12 smokers' lungs with scanning electron microscopy in order to analyze the distribution and size of alveolar fenestrae and their relationship to the average distance between alveolar walls (Lm) and lung function. Alveolar fenestrae in areas near terminal airways (respiratory bronchioles and alveolar ducts) were consistently larger than fenestrae far from airways (alveoli). Fenestrae in near areas increased in size as Lm increased (r = 0.845, p less than 0.001), whereas no correlation between Lm and fenestrae size in far areas was found (r = 0.281, NS). The overall area of fenestrae (near and far) correlated significantly with FEV1 (r = -0.745, p less than 0.01), MMEF (r = -0.752, p less than 0.01), and PL90 (r = -0.804, p less than 0.05). However, when subdivided into near and far, only fenestrae near the small airways showed a significant correlation with function. These findings suggest that in smokers with mild to moderate emphysema, destruction affects preferentially the areas around the terminal airways (near areas), and these changes, although small, might play an important role in the lung function.
我们用扫描电子显微镜研究了12名吸烟者的肺部，以分析肺泡小孔的分布和大小、它们与肺泡壁平均距离（Lm）的关系以及与肺功能的关系。终末气道（呼吸性细支气管和肺泡管）附近区域的肺泡小孔始终比远离气道（肺泡）的小孔大。靠近区域的小孔大小随Lm增加而增大（r = 0.845，p小于0.001），而在远离区域未发现Lm与小孔大小之间存在相关性（r = 0.281，无显著性差异）。小孔的总面积（靠近和远离区域）与第一秒用力呼气容积（FEV1）（r = -0.745，p小于0.01）、最大呼气中期流速（MMEF）（r = -0.752，p小于0.01）和第90百分位呼气流量（PL90）（r = -0.804，p小于0.05）显著相关。然而，当分为靠近和远离区域时，只有小气道附近的小孔与功能有显著相关性。这些发现表明，在轻度至中度肺气肿的吸烟者中，破坏优先影响终末气道周围区域（靠近区域），并且这些变化尽管微小，但可能在肺功能中起重要作用。
