摘要
目的:研究慢性支气管炎(慢支)、肺气肿气道及肺部炎症在肺动脉重塑中的作用。方法:24只雄性Wistar大鼠分3组,每组8只;慢支、肺气肿4周组(A组)、慢支、肺气肿6周组(B组)、正常对照组(C组)。气管内注入脂多糖(LPS)和每天烟熏的混合刺激方法制作慢支、肺气肿动物模型。测定各组血气分析、肺血流动力学和肺泡灌洗液(BALF)细胞分类计数;观测气道、肺泡组织及肺血管的病理组织学改变。结果:(1)A、B组BALF细胞总数显著高于C组,细胞分类及气道壁浸润的细胞中,A组以中性粒细胞为主,B组以淋巴细胞、单核巨噬细胞为主,其气管、支气管及肺组织具有慢支、肺气肿的病理特征。(2)A、B组右心室收缩压(RVSP)、平均肺动脉压(mPAP)、右心室与左心室+室间隔重量比(RV/LV+S)高于C组(P<0.05)。A、B肌化型动脉(MA)数量比亦高于C组(P<0.05)。(3)A、B组MA百分比、mPAP与平均肺泡面积,BALF细胞总数和中性粒细胞、淋巴细胞、单核巨噬细胞对小气道浸润程度呈正相关,与PaO2无相关性。在A组中,MA百分比、mPAP与BALF细胞数的中性粒细胞百分比呈正相关,而在B组中,与淋巴细胞百分比、单核巨噬细胞百分比呈正相关。结论:(1)慢支、肺气肿在无低氧血症时已出现肺动脉高压、右心室肥厚及肺动脉重塑,其发生机制与气道及肺部的炎症浸润及炎症破坏程度相关。(2)此阶段肺动脉重塑改变以肺小动脉肌化为主要特点,并与肺血流动力学改变呈正相关。
AIM ： To study the effects of airway and pulmonary inflammation on pulmonary arterial remodeling in rats with chronic bronchitis （ CB ） and emphysema. METHODS： Twenty - four male Wistar rats were divided into three groups （n=8） ： Group A： four- weeks CB and emphysema; Group B： six -weeks CB and emphysema group; Group C： normal control. The rat model of CB and emphysema was established by intratracheal instillation of lipopolysaccharide （LPS） and daily exposure to cigarette smog. The arterial blood gas analysis, pulmonary hemodynamics changes and cell counts in bronchoalveolar lavage fluid （BALF） were measured. The pathomorphological changes of airway inflammation, alveoli destruction and pulmonary arterial remodeling were observed by HE straining and triple straining. RESULTS ： （ 1 ） The characteristic pathological changes of CB and emphysema were observed in group A and B. Neutrophils were the main cells infiltrated into the walls of airway in group A. Lymphocytes and macrophages were the main cells in group B. （2） Right ventricular systolic pressure （RVSP）, mean pulmonary arterial pressure （mPAP）, the ratio of the weight of right ventricle/left ventricle and septum （ RV/LV ＋ S） in group A and B were significantly higher than those in group C （ P 〈 0. 05 ）. The amount of muscular artery （MA） in group A and B were significantly higher than that in group C （ P 〈 0. 05 ）. （ 3 ） In group A and B, the levels of MA, RVSP, mPAP and RV/LV ＋ S was correlated positively with the average alveolar area, the total cell counts and differential cell counts of neutrophils, lymphocytes and macrophages in BALF, and the level of infiltration into the walls of airway, respectively （P 〈 0. 05 ）. The positive correlation was observed with the percentage of neutrophils, lymphocytes and macrophages between group A and B （ P 〈 0. 05）. The amounts of MA were also correlated positively with RVSP, mPAP and RV/LV ＋ S （ P 〈 0. 05 ）. CONCLUSIONS ： （ 1 ） The pulmonary artery hypertension, the right ventricular hypertrophy and the pulmonary arterial remodeling appeared before hypoxia. These may be related with the degree of the pulmonary inflammation. （2） The characteristic of pulmonary arterial remodeling was small artery organization, and correlated positively with the changes of hemodynamics.
出处
《中国病理生理杂志》
CAS
CSCD
北大核心
2006年第9期1811-1815,共5页
Chinese Journal of Pathophysiology
基金
广西自然科学基金资助项目(No.桂科字0229024)
关键词
支气管炎
慢性
肺气肿
炎症
肺动脉复建
Bronchitis, chronic
Pulmonary emphysema
Inflammation
Pulmonary arterial remodeling
