摘要
探讨特发性肺纤维化（ＩＰＦ）经支气管肺活检（ＴＢＬＢ）组织胶原分型测定的临床意义。方法对２５例ＩＰＦ患者ＴＢＬＢ标本和１０例正常肺组织应用免疫组化染色法，进行Ⅰ型和Ⅲ型胶原（ＣｏｌⅠ和ＣｏｌⅢ）的半定量测定；并检测１３例的支气管肺泡灌洗液（ＢＡＬＦ）的细胞成分，随访１７例激素疗效，结合病程和病变程度进行综合分析。结果ＩＰＦ肺组织Ⅰ、Ⅲ型胶原沉积量较正常肺组织不同程度增多；病程短（≤３月）、病变程度轻（Ⅰ、Ⅱ级）者，肺组织中ＣｏｌⅢ占优势，病程长（＞２４月）、病变较重（Ⅲ、Ⅳ级）者，则以ＣｏｌⅠ为主；治疗有效组，ＣｏｌⅢ／ＣｏｌⅠ≥１，无效组ＣｏｌⅢ／ＣｏｌⅠ＜１（Ｐ＜０．０１）；ＣｏｌⅢ／ＣｏｌⅠ≥１者，ＢＡＬＦ中性粒细胞百分比明显增高（Ｐ＜０．０５）。结论多部位取材ＴＢＬＢ标本进行胶原分型测定和比例分析，可以较好地辅助判断ＩＰＦ病变程度和活动性。
PURPOSE To evaluate the clinical significance of collagen typing in lung specimens from patients with idiopathic pulmonary fibrosis(IPF). METHODS Immunohistochemical study was carried out for semiquantitative detection of collagen type Ⅰ and type Ⅲ in transbronchial lung biopsy(TBLB) specimens from 25 cases with IPF and 10 normal controls. Cellular components of bronchoalveolar lavage fluids (BALF) in 13 cases of them were determined. 17 patients were treated with glucocorticoid. RESULTS The study revealed a different increase in both collagen types was observed in IPF lung specimens; a significant relationship between the ratio of collagen type Ⅲ/type Ⅰ and the course of disease, degree of pathological change and glucocorticoid treatment response ( P <0.05 or P <0.01);The significant relation was also observed in the ratio of both collagen types and the percentage of neutrophils in BALF ( P <0.05). CONCLUSIONS The ratio of collagen type Ⅲ/type Ⅰwith immunohistochemical semiquantitative detection may be helpful to diagnose disease activity of IPF.
出处
《上海医科大学学报》
CSCD
1998年第6期424-427,共4页
Journal of Fudan University(Medical Science)
基金
江苏省教委自然基金
关键词
特发性
肺纤维化
胶原
支气管肺泡灌洗
idiopathic pulmonary fibrosis
collagen
bronchoalveolar lavage
