Song W D, Zhang A C, Pang Y Y, Liu L H, Zhao J Y, Deng S H, Zhang S Y
Department of Pulmonary Medicine, First Affiliated Hospital, Anhui Medical University, PR China.
Respiration. 1995;62(3):125-9. doi: 10.1159/000196406.
Fibronectin (FN) and hyaluronan (HA) in bronchoalveolar lavage fluid (BALF) and FN released by alveolar macrophages (AM) were examined in 7 nonsmoking healthy control subjects, and 20 smoking patients with chronic obstructive pulmonary diseases (COPD). All patients and subjects were no more than 40 years old. According to the 95% confidence limits of HA and FN in BALF from nonsmoking healthy control subjects, the smoking patients were divided into two groups, those who had HA and FN levels within the limits for nonsmoking controls were classified as the first group (group 1) and those with levels above the control limits were classified as the second group (group 2). Our data showed that the concentrations of HA and FN in BALF and FN released by AM were significantly higher in group 2 than in group 1 patients. There were also significant differences between the two groups in pulmonary function measurements (DLco, FEV1, and FEV1/FVC) which were lower in group 2. HA levels in group 2 patients correlated directly with counts of inflammatory cells in BALF (BALF cells/ml, and numbers/ml of total cells, macrophages, neutrophils and lymphocytes), and the concentration of FN released by AM, and showed an inverse correlation with pulmonary function (DLco and FEV1/FVC). Our results suggest that the inflammatory repair response and fibrosis may play a role in the development of emphysema in young patients with COPD.
对7名不吸烟的健康对照者和20名患有慢性阻塞性肺疾病（COPD）的吸烟患者的支气管肺泡灌洗液（BALF）中的纤连蛋白（FN）和透明质酸（HA）以及肺泡巨噬细胞（AM）释放的FN进行了检测。所有患者和对照者年龄均不超过40岁。根据不吸烟健康对照者BALF中HA和FN的95%置信区间，将吸烟患者分为两组，HA和FN水平在不吸烟对照者范围内的患者被归为第一组（第1组），水平高于对照范围的患者被归为第二组（第2组）。我们的数据显示，第2组患者BALF中HA和FN的浓度以及AM释放的FN显著高于第1组患者。两组在肺功能指标（一氧化碳弥散量、第一秒用力呼气容积和第一秒用力呼气容积/用力肺活量）上也存在显著差异，第2组的这些指标较低。第2组患者的HA水平与BALF中的炎症细胞计数（BALF细胞/毫升以及总细胞、巨噬细胞、中性粒细胞和淋巴细胞的数量/毫升）以及AM释放的FN浓度直接相关，并且与肺功能（一氧化碳弥散量和第一秒用力呼气容积/用力肺活量）呈负相关。我们的结果表明，炎症修复反应和纤维化可能在年轻COPD患者肺气肿的发生发展中起作用。
