摘要
肺动脉高压是慢性阻塞性肺病 (COPD)的并发症之一 ,在组织学上以血管重建为特征 ,其病因知之甚少。我们曾报道 ,高原地区大鼠重建的肺动脉周围肥大细胞类胰蛋白酶及转化生长因子 β1(TGF β1)免疫组织染色呈高值 ,但COPD患者是否会发生这种改变尚未明了。为阐明此事 ,我们选择 10名严重肺气肿并接受肺容量恢复术的患者作为实验组 ;另选 5名肺周围型癌并接受肺叶切除的患者作为对照组。对肥大细胞类胰蛋白酶及TGF β1的免疫组织化学研究表明 ,COPD肺动脉外径厚度达 10 0～ 2 0 0 μm ,而对照组平均分别为 36.4± 4 .5 %或 2 2 .6± 3%(P <0 .0 5 ) ,COPD患者血管和小气道周围的肥大细胞胰蛋白酶阳性数量与对照组相比显著增加(P <0 .0 1) ,且与血管厚度呈正相关 (r =0 .85 ,P <0 .0 1) ,COPD患者肺中性粒细胞及单核细胞内TGF β1免疫染色呈强阳性 ,但却未在对照组内测到。上述结果表明 ,肥大细胞胰蛋白酶和TGF β1的过量表达可能由气道慢性炎症及低氧血症所致。
Pulmonary hypertension,which is a complication of chronic obstructive pulmonary disease (COPD),is characterized histologically by vascular remodeling.However,the latter is poorly understood from a pathogenic standpoint.We previously reported that mast cell tryptase and transforming growth factor β 1(TGF β 1) were highly immunostained around remodeled pulmonary arteries in rats who lived at high altitude,but it whether or not these changes are present in COPD patients is unknown.To clarify this,we performed histological and immunohistochemical studies on the pulmonary artery in 10 patients with severe emphysema who underwent lung volume reduction surgery and 5 nonsmokers with small peripheral lung cancer who underwent lobectomy as controls.Immunohistochemistry was performed for the mast cell tryptase,and transforming growth factor beta 1(TGF β 1).Percent wall thickness of pulmonary arteries with external diameters of 100 200μm in COPD patients and controls were 36.0±4.5% and 22.6±3.3%(P<0.05),respectively.The number of tryptase positive mast cells around vessels and small airways in COPD patients was greatly increased compared to that of the controls(P<0.01),and it was well correlated with wall thickness of vessels (r=0.85,P<0.01).TGF β 1 immunostaining was intense in the neutrophils and mononuclear cells of the lung in COPD patients,whereas it was not detected in controls.These findings suggest that overexpression of mast cell tryptase and TGF β,which may be caused by chronic airway inflammation hypoxemia and/of hypoxemia,plays an important role in modulating vascular remodeling in the patients with COPD.
出处
《青海医学院学报》
CAS
2002年第1期1-7,共7页
Journal of Qinghai Medical College
