高原肺水肿16例临床病理学观察

clinicopathologic observation on High altitude pulmonary edema of 16 cases

报道了16例高原肺水肿病理组织学和超微结构改变。总结了本病的临床病理特点并讨论了发病机理。本组资料均为移居高原汉族，男13例，女3例，发病海拔高度3060～4507m。双肺重1229～2370g。光镜观察肺泡腔普遍有水肿，6例小血管壁增厚，7例见纤维蛋白血栓，8例肺透明膜形成，10例肺泡腔出血，8例支气管炎和支气管肺炎，7例肺不张。电镜观察肺泡Ⅱ型细胞损害较重，肺毛细血管细胞连接间隙增宽，气血屏障结构变薄等。本病根本原因系高原急性缺氧所致。临床早诊断早治疗尤为重要。

Histopathological and ultrasructural changes were examined in 16 cases of high altitude pulmonary edema and the clinicopathologic and pathogenesis discussed.of 16 subjects, 13 were men and 3 women, who lived at 3060 to 4507 metres above sea level. Both their lungs weighed 1229 to 2370 grams. Light microscopic observation showed that their alveolar edema in all cases,thickened walls of small blood vessels in 6 cases, thrombosis of fibrin in 7 cases,hyaline membranes in 8 cases,alveolar hemorrhage in 10 cases, bronchitis and bronchopneumonia in 8 cases. It was also found under electron microscopy that cells of type 2 in alveoli were damaged, cellar connective spaces of capillaries in lungs increased and gas-blood barriers thinned. It is concluded that this kind of edema is caused by high altitude anoxia and its early diagnesis is of great importance.