吸烟者肺泡破坏指数的测定及其与肺功能损害的相关性研究

The study on the relationship between the index of lung parenchyma destruction and the deterioration of pulmonary function in smokers

目的探讨吸烟者肺泡、肺泡囊破坏情况与肺功能损害的相关性。方法13例吸烟者术前进行肺功能测定,手术切除肺标本经支气管灌注固定、矢状位取材、常规HE染色制片,光镜下以点计数法计数肺泡破坏指数(DI)。结果肺泡破坏指数值与FEV1/FVC%显著负相关(r=-06324,P=001),与TLC%pred显著正相关(r=06605,P<001)。慢性阻塞性肺疾病(COPD)组高于对照组,且差异显著(P<001)。结论肺泡破坏指数测定是一种简单、可靠、可重复性高的衡量肺气肿的程度和严重性的方法。肺泡破坏指数值可以反映出吸烟者肺通气阻塞的程度,肺总量增加的程度,与临床阻塞性肺气肿的诊断及分级的相关性高。

Objective To analyze the relationship between the index of lung parenchyma destruction and pulmonary function deterioration in smokers.Methods The lung lobes of 13 smokers who received surgical operations were fixed by intrabronchical infusion of 10% formalin with a pressure maintained at 25 cm of water for 24～48 h.The specimens were cut sagittally into slices of 0 3 cm away from the tumor site.Sections of 6 μm thick were stained with Harris and Eosin for light microscopy.Using a point count system,parenchyma destruction index (DI) was quantitated,then the association of DI with pulmonary function was analyzed.Results The DI correlated well with FEV 1 /FVC%( r =-0 6324, P =0 01) and TLC%pred ( r =0 6605, P <0 01) in smokers.In addition,the DI was significantly different between the controls groups and chronic obstructive pulmonary disease (COPD) groups ( P <0 01).Conclusions The measurement of the DI is an feasible,reliable and reproducible microscopic technique to quantitate lung parechymal destruction.Increased destructive index correlated with deterioration of lung function in patients with COPD.