吸烟者肺泡接触段破坏及其与小气道形态异常的关系

Lossofalveolaratachmentsinsmoker′slungsanditsrelationtosmalairwayabnormalities

为观察吸烟者肺泡接触段和小气道形态的计量特点，以探讨吸烟者肺泡接触段破坏的发生与小气道形态异常的关系。应用图象分析技术对３６例吸烟者肺泡接触段和小气道形态进行计量学分析。分为：无肺气肿组（ＮＥ），小叶中央型肺气肿组（ＣＬＥ）和全小叶型肺气肿组（ＰＬＥ）。肺泡接触段参数中，ＣＬＥ的相邻两个正常肺泡接触段之间的距离（距离）和异常肺泡接触段百分数（异常接触数％）显著高于ＮＥ（Ｐ＜０．０５和Ｐ＜０．０１），三组间的正常肺泡接触段参数无明显区别；小气道形态参数中，ＣＬＥ的小气道管壁面积（ＷＡ）和扭曲系数（ＤＩ）明显不同于ＮＥ（均Ｐ＜０．０５）；ＰＬＥ和ＮＥ间这些参数均无明显区别；距离和异常接触数的百分率分别与ＷＡ和ＤＩ显著相关，但这种关系仅见于ＣＬＥ。说明吸烟者肺泡接触段的破坏与小气道形态异常有密切关系，提示不同类型的肺气肿ＣＬＥ和ＰＬＥ可能各自有完全不同的发病机制。

Thealveolaratachmentsandsmalairwayabnormalitiesinthelungsofsmokersweremeasuredbycomputerizedimagingtostudytherelationshipbetweenlossofalveolaratachmentsandsmalairwayabnormalities.thesmoker′slungsweredividedintothreegroups:noemphysema(NE),cen-trilobularemphysema(CLE)andpanlobularemphysema(PLE).Thedistancebetweennormalalve-olaratachments(Distance)andpercentabnormalalveolaratachments(%Abnormal)inCLEweresig-nifi-cantlyhigherthaninNE(P<0.05andP<0.01),andnosignificantdiferenceinthenumberofnormalalveolaratachmentsinthe3groups.Thesmalairwaywalarea(WA)anddeformityindex(DI)inCLEdiferedsignificantlyfromMAandDIinNE(P<0.05foral).TherewerenodiferencesbetweenPLEandNEintheseindices.Distanceand%AbnormalcorrelatedsignificantlywithWAandDI,butthecore-lationswereshownonlyinCLE.Weconcludedthatalveolaratachmentdestructioninsmoker′slungswascloselyassociatedwithsmalairwayabnormalities,whichindicatedthedifferentpat-ternsofem-physema,CLEandPLE,probablyhavediferentpathogenesisrespectively.