小气道病变患者小气道黏膜层免疫病理的变化

探讨小气道病变患者小气道黏膜层的免疫病理学特点。86例因肺局限性病变需行肺叶切除患者，分为小气道病变组34例、COPD组22例及肺功能正常组30例。收集术后肺标本，应用免疫组化法检测小气道黏膜层内CD3^ 、CD8^ 、CD68^ 、CD45RA^ 、CD45RO^ 、CD20^ 细胞，并与FEV1．0、V50、V25做相关性分析。小气道病变组、COPD组CD3^ 、CD8^ 、CD68^ 细胞数明显高于正常组；而小气道病变组与COPD组相比无差异；小气道病变组CD8^ 细胞数与V50呈显著负相关；正常组内吸烟者CD45R0^ 细胞数明显高于非吸烟者；在小气道病变组或COPD组内，吸烟与非吸烟者之间CD3^ 、CD8^ 、CD45RO^ 细胞数均无差异；小气道病变组内非吸烟者CD68^ 细胞数高于吸烟者及正常非吸烟者。T淋巴细胞尤其CD8^ 细胞及CD68^ 细胞在小气道病变及COPD炎性过程中有重要意义，吸烟可导致CD45RO^ 细胞在小气道黏膜集聚，CD68^ 在非吸烟因素致小气道病变中意义更大。

Immunopathological changes of the small airway mucosa in patients with small airway diseases

To investigate the immunopathological characters of the small airway mucosa in small airway diseases.Eighty six patients undergoing lung resection for localized pulmonary lesions were involved.They were divided into three groups : 34 cases of small airway disease; 22 cases of COPD; 30 cases of normal lung function subjects. Surgical specimen were obtained from operation. Immunohistochemical methods were performed to identify CD3 +, CD8 +,CD20 +,CD45RA +,CD45RO + and CD68 + cells infiltrated in the airway wall and make interrelated analysis with FEV1.0,V50 ,V25.The number of CD3 +,CD8 + lymphocytes and CD68 + cells was increased in the small airway disease and COPD compared with normol lung function group ,and there was no difference between the small airway disease and COPD. There was a significant negative correlation between the CD8 +T-cell and V50 percentage of the predicted in the small airway disease group. The numeber of the CD45RO + cells was more in the smokers than that in the nonsmokers in the normal pulmonary function group. No difference in the numbers of CD3 +, CD8 +,CD45RO + cells was found between the smokers and the nonsmokers in the small airway disease or COPD group. While the number of CD68 +cell was more in the nonsmokers with the small airway disease than that in the smokers and than that in the nonsmokers with the normol pulmonary function .The infiltration of the T lymphocytes especially CD8 + cell and CD68 + cell play an important role in the small airway inflammation in the small airway disease and COPD. T lymphocytes especially CD8 + cells and CD68 + cells are of great importance in the small airway disease and COPD inflammation.Smoking may induce the increasing of the CD45RO + cells in the small airway wall. CD68 + cell infiltrating into mucosa has more impact on the nonsmokers with the small airway disease than that in the smokers