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普通人群中不吸烟者大气道内隆突和管状气道颗粒浓度:气道隆突处颗粒浓度高的证据。

Carinal and tubular airway particle concentrations in the large airways of non-smokers in the general population: evidence for high particle concentration at airway carinas.

作者信息

Churg A, Vedal S

机构信息

Department of Pathology, University of British Columbia, Vancouver, Canada.

出版信息

Occup Environ Med. 1996 Aug;53(8):553-8. doi: 10.1136/oem.53.8.553.

Abstract

OBJECTIVE

To evaluate the extent to which human airway carinas accumulate ambient atmospheric particles, a newly developed technique was used to micro-dissect and analyse particle concentration in tubular segments and carinas of the large airways of 10 necropsy lungs from non-smokers from the general population of Vancouver.

METHODS

Ratios of the particle concentrations on the carinas to the tubular segment immediately preceding it were measured with analytical electron microscopy for the mainstem bronchus, upper and lower lobe bronchi, and four different segmental or subsegmental bronchi--that is, Weibel generations 1 to about 5. A total of 119 carinal-tubular pairs was evaluated.

RESULTS

Over all cases, both carinal and tubular particle concentrations increased with increasing airway generation; the median ratio of carinal to tubular particle concentration was 9:1 and did not show any trend with airway generation. The ratio was > 5 in 71% of carinal-tubular pairs, > 10 in 42% of pairs, > 20 in 31% of pairs, and > 100 in 9% of pairs. Some subjects showed a notable tendency to high ratios, with many ratios > 100, and other subjects had a tendency toward low ratios. The predominant mineral species in both carinas and tubular airway segments was crystalline silica and the relative proportion was similar in both sites; however, mean particle diameter was consistently less in the carinal tissues.

CONCLUSIONS

These findings suggest that the ratio of carinal to tubular retained particles in the large airways in non-smokers is higher than might be supposed from data generated in airway casts, and that there is considerable variation in this ratio between subjects. This finding is of potential interest in models of carcinogen, toxin, and dose of fibrogenic agent to the large airways as it suggests high and sometimes extreme concentrations of toxic particles at carinas, and thus reinforces the notion that carinas may be sites of initiation of disease.

摘要

目的

为评估人类气道隆突积聚环境大气颗粒物的程度,采用一种新开发的技术,对来自温哥华普通人群的10例非吸烟者尸检肺脏的大气道管状节段和隆突进行显微解剖并分析颗粒物浓度。

方法

使用分析电子显微镜测量主支气管、上叶和下叶支气管以及4种不同的节段性或亚节段性支气管(即韦贝尔第1代至约第5代)隆突处与紧邻的管状节段的颗粒物浓度比值。共评估了119对隆突 - 管状节段。

结果

在所有病例中,隆突和管状节段的颗粒物浓度均随气道分级增加而升高;隆突与管状节段颗粒物浓度的中位数比值为9:1,且未显示出随气道分级的任何趋势。71%的隆突 - 管状节段对该比值大于5,42%的节段对大于10,31%的节段对大于20,9%的节段对大于100。一些受试者呈现出高比值的显著倾向,许多比值大于100,而其他受试者则倾向于低比值。隆突和管状气道节段中的主要矿物种类均为结晶二氧化硅,且两个部位的相对比例相似;然而,隆突组织中的平均粒径始终较小。

结论

这些发现表明,非吸烟者大气道中隆突与管状节段留存颗粒物的比值高于气道铸型数据所推测的水平,且该比值在个体之间存在相当大的差异。这一发现对于大气道致癌物、毒素和致纤维化剂剂量模型具有潜在意义,因为它表明隆突处存在高浓度甚至有时是极高浓度的有毒颗粒物,从而强化了隆突可能是疾病起始部位的观点。

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