小气道病变与病理关系的探讨

目的：探讨小气道病变与病理关系。方法：86例肺部局限性病变患者，依据术前的病史和肺功能分为3组。正常组30例，小气道病变组34例，慢性阻塞性肺疾病（COPD）组22例。利用手术的肺标本HE染色探讨其病理学特点并与临床资料比较。结果：小气道病变组炎性细胞浸润、平滑肌肥厚积分明显高于正常组；小气道病变组及COPD组气道粘膜层淋巴细胞数明显高于对照组；小气道病变组结缔组织增生、平滑肌肥厚积分为V50、V25显著负相关；COPD组炎性细胞浸润与FEV1．0及V50显著负相关。结论：小气道病变病理改变主要为炎性细胞浸润及平滑肌肥厚，而炎性细胞以淋巴细胞为主；小气道病变功能异常与气道重建有关。

Relationship between small airway lesion and pathological changes

Objective: To study the the relationship between small airway lesion and pathological changes. Methods: 86 subjects with limited lung lesions were divided into three groups in according to the state of lung function and cace histories before operation:30 cases of normal subjects 34 cases of small airway lesions and 22 cases of COPD. Lung specimens obtained from lung resection were investigated for pathological characters by H-E staining. Result: The scores of inflammatory cell infiltration and smooth muscle hypertrophy were significantly higher in the cases of small airway lesion than in the normal. and the number of lymphocytes in the mucosa layer as significantly higher in caces of small airway lesion and COPD than in the normal group. The score of smooth muscle hypertrophy as obviously negatively correlated with 50 and 25. and the degree of inflammatory cell infiltration in COPD showed obvious negative correlation with FEV1.0 and 50 and 25. Conclusion: The results show that the major pathological changes were inflammatory cell infiltration and smooth muscle hypertrophy, lymphocyte being the maior inflammatory cell of infiltration. Airway rebuild may contribute beneficially to function changes in small airway lesion.