Levcheva V
Vutr Boles. 1983;22(5):13-7.
The defects in case of interrupted development of broncho-pulmonary systems are intranatal, perinatal and postnatal deviations from its normal development. They could be: 1) aplasias; 2) hypoplasias; 3) dysplasias. The aplasias are early intranatal dysembryopathies, originating under the effect of epigenetic and paragenetic factors. In classical aplasias, the rudimentary development of a bronchus, first and second generation is the absence of pulmonary parenchyma, is concerned. In aplasias of the air passages of third, fourth, etc. generations, the primitive mesoderm could undergo cyst-like formation via independent differentiation to "primitive air spaces", with collagenous ventilation without direct bronchial communication. The hypoplasias are defects, associated with the abortive development both of air passages and the pulmonary parenchyma under the effect of paragenetic factors. They are manifested in four forms: 1) classical hypoplasias; 2) hypoplasias with cylindrically dilated bronchi; 3) hypoplasias with ampullarly dilated bronchi; 4) late hypoplasias. There are numerous intermediate forms among those basic forms, confirming their pathogenetic common origin and justifies their inclusion in the common group. The classical hypoplasias correspond to the description given by P. Schneider (1912). The hypoplasias with cylindrically dilated bronchi correspond to the so-called congenital cylindric bronchiectasis. The hypoplasias with ampullar dilations of bronchi correspond to the so-called congenital ampullar bronchiectasis. The late hypoplasias correspond to the so-called dysontogenetic bronchiectasis. In our opinion, the term hypoplasia, in pathologoanatomical and pathogenetic sense, is more informative and reflects the associated abortive development of the air passages and pulmonary parenchyma.
支气管肺系统发育中断情况下的缺陷是出生前、围产期和出生后与其正常发育的偏差。它们可能是:1)发育不全;2)发育不良;3)发育异常。发育不全是早期出生前发育异常病,起源于表观遗传和旁遗传因素的影响。在典型的发育不全中,涉及支气管第一代和第二代的初步发育,即肺实质缺失。在第三代、第四代等气道发育不全中,原始中胚层可通过独立分化形成囊肿样结构,形成“原始气腔”,有胶原性通气但无直接支气管相通。发育不良是与旁遗传因素作用下气道和肺实质发育不全相关的缺陷。它们表现为四种形式:1)典型发育不良;2)伴有圆柱形扩张支气管的发育不良;3)伴有壶腹样扩张支气管的发育不良;4)晚期发育不良。在这些基本形式之间有许多中间形式,证实了它们在发病机制上的共同起源,并证明将它们归入同一组是合理的。典型发育不良与P. 施奈德(1912年)给出的描述相符。伴有圆柱形扩张支气管的发育不良对应于所谓的先天性圆柱形支气管扩张。伴有支气管壶腹样扩张的发育不良对应于所谓的先天性壶腹样支气管扩张。晚期发育不良对应于所谓的发育异常性支气管扩张。我们认为,从病理解剖学和发病机制的角度来看,发育不良这个术语更具信息量,并且反映了气道和肺实质相关的发育不全。