三步序贯法对哮喘大鼠气道重塑激素干预模型支气管肺组织病理形态学的影响

目的探讨光镜、电镜观察三步序贯法对哮喘大鼠气道重塑激素干预模型支气管肺组织病理形态学的影响。方法模拟临床激素依赖型哮喘患者激素撤减过程,建立哮喘大鼠气道重塑激素干预模型,150只大鼠随机分为气道重塑组、地塞米松干预组、普米克令舒组、三步序贯组及正常对照组。光镜、电镜下观察各组大鼠支气管肺组织形态学改变,并测定支气管壁厚度、支气管平滑肌厚度及支气管平滑肌细胞核数量的变化。结果光镜下肺组织HE染色,各组致敏大鼠可见不同程度炎细胞浸润,三步序贯组炎症反应明显减轻;光镜下Masson三色染色,气道重塑组肺间质胶原纤维大量沉积,地塞米松干预组激素撤减过程中亦出现胶原纤维沉积增多,而三步序贯组及普米克令舒组较以上2组明显减少。支气管壁厚度,激素撤减前三步序贯组与气道重塑组相比明显减低(P0.01),激素撤减中三步序贯组与气道重塑组、地塞米松干预组相比减低(P0.01、P0.05),激素撤减后三步序贯组与气道重塑组、地塞米松干预组相比均明显减低(P0.01);支气管平滑肌厚度,激素撤减前三步序贯组与气道重塑组、地塞米松干预组相比均无差别(P0.05),激素撤减中三步序贯组与气道重塑组、地塞米松干预组相比均减低(P0.05),激素撤减后三步序贯组与气道重塑组、地塞米松干预组相比均明显减低(P0.01);支气管平滑肌细胞核数量,激素撤减前三步序贯组与气道重塑组、地塞米松干预组相比减低(P0.01、P0.05),激素撤减中、后三步序贯组与气道重塑组、地塞米松干预组相比均明显减低(P0.01)。电镜观察,地塞米松干预组激素撤减中、后与气道重塑组情况接近,而三步序贯组及普米克令舒组激素撤减过程中气道上皮细胞纤毛脱落情况明显改善。结论三步序贯法能够明显减轻哮喘模型大鼠支气管肺组织病理形态学方面的炎性改变,从而对气道重塑起到阻抑作用。

Three-step sequential therapy on pathomorphology of bronchial lung tis-sues of asthmatic rat airway remodeling after hormone intervention

Objective To observe the effect of three-step sequential therapy on the pathomorphology of the bronchial lung tissues of rat asthmatic model with airway remodeling after hormone intervention using light microscope and electron microscope.Methods The airway remodeling of asthmatic rats model was induced by hormone intervention to simulate hormone withdrawal (HW)of steroid dependent asthma (SDA)patients.Altogether 150 rats randomly divided into five groups (each n =30)of airway remode-ling group,dexamethasone intervention group,pulmicort group,three-step sequential therapy group and normal control group.Morphological changes of the bronchial lung tissues of rats of all groups were ob-served under light microscope and electron microscope,and thicknesses of the bronchial walls and the bronchial smooth muscle and the number of the cell nucleus in the bronchial smooth muscle were meas-ured.Results Using HE staining,the lung tissues of rats except for those in normal control group were infiltrated by inflammation cells with different degrees,but the rats of three-step sequential therapy group were observed significantly slight inflammatory reaction.Using Masson trichromatic staining,massive col-lagen fiber in pulmonary interstitial of airway remodeling group deposited,while deposition increased dur-ing hormone withdrawal in dexamethasone intervention group,and significantly less deposition was ob-served in both three-step sequential therapy group and pulmicort group.Before HW,the thickness of the bronchial walls in three-step sequential therapy group decreased significantly compared with that in airway remodeling group(P <0.01);during and after HW,the thickness of the bronchial walls in three-step se-quential therapy group decreased compared with dexamethasone intervention group and airway remodeling group(P <0.01,P <0.05).Before HW,there is no difference (P >0.05)of bronchial smooth muscle thickness observed in all the medication groups;during and after HW,bronchial smooth muscle thickness decreased compared with dexamethasone intervention group and airway remodeling group(P <0.01,P <0.05).The number of cell nucleus in the bronchial smooth muscle of three-step sequential therapy group decreased significantly,regardless of HW,compared with dexamethasone intervention group and airway remodeling group(P <0.01).Using electron microscope,airway epithelial cilia falling off was remark-ably alleviated during HW in three-step sequential therapy group and pulmicort group,while that in dexa-methasone intervention group during or after HW was the same as the airway remodeling group. Conclusion Three-step sequential therapy could inhibit the airway remodeling by the way of relieving inflammatory changes of the bronchial lung pathomorphology of rat asthmatic model.