Anderson W R, Strickland M B, Tsai S H, Haglin J J
Am J Pathol. 1973 Nov;73(2):327-48.
Alterations of lung tissues were evaluated in 74 infants with respiratory distress who received respirator therapy and high concentrations of oxygen for varying durations. Infant survival ranged from 3 hours to 135 days. Sequential pathologic changes were revealed to be an exudative reaction superimposed upon the early stages of typical hyaline membrane disease. This merged with and was eventually replaced by a reparative fibroproliferative response that was most pronounced in those infants who survived for the longest period of time. This response appeared causally related to the development of pulmonary complications of interstitial fibrosis, emphysema, obliterative bronchiolitis and cystic bronchiolectasis. Correlative ultrastructural studies disclosed generalized capillary endothelial damage in early stages of oxygen therapy, interstitial edema and alteration of alveolar cells attributed to the toxic effects of oxygen. Proliferation of type 2 alveolar cells with incorporation of hyaline membranes into septal walls was a notable feature of the reparative reaction and appeared significant in the subsequent development of interstitial fibrosis.
对74例接受呼吸机治疗并吸入不同时长高浓度氧气的呼吸窘迫婴儿的肺组织改变进行了评估。婴儿存活时间从3小时至135天不等。连续的病理变化显示为典型透明膜病早期叠加的渗出反应。这种反应与修复性纤维增生反应融合，并最终被其取代，这种反应在存活时间最长的婴儿中最为明显。这种反应似乎与间质性纤维化、肺气肿、闭塞性细支气管炎和囊性细支气管扩张等肺部并发症的发生有因果关系。相关的超微结构研究揭示，在氧疗早期存在广泛性毛细血管内皮损伤、间质水肿以及由于氧的毒性作用导致的肺泡细胞改变。Ⅱ型肺泡细胞增殖并将透明膜纳入间隔壁是修复反应的一个显著特征，并且在随后的间质性纤维化发展中似乎具有重要意义。
