慢性阻塞性肺疾病患者纤毛摆动时间的研究  

Cilia beat time of the patients with chronic obstructive pulmonary disease

作　　者：高志睿[1] 高兴林[1] 吴一龙 陈刚 吴建[1] 罗少华[1] 李东风 

机构地区：[1]广东省人民医院东病区呼吸内科广东省医学科学院广东省老年医学研究所,广州510080 [2]广东省肺癌研究所 [3]广东省肺癌研究所胸外科 [4]广东省肺癌研究所医学研究中心

出　　处：《国际呼吸杂志》2011年第13期984-988,共5页International Journal of Respiration

摘　　要：目的探讨慢性阻塞性肺疾病（COPD）患者纤毛摆动时间和肺功能的关系，及黏液纤毛清除功能（MCC）在COPD发病中的作用。方法手术切除的支气管组织30例，分为COPD组、吸烟组及对照组，每组10例，光镜下观察活性纤毛细胞的百分率及纤毛摆动时间，并计数各个时间点的摆动纤毛细胞的百分率，收集临床资料包括吸烟指数、体质量指数、肺功能，分析活性纤毛细胞百分率、纤毛摆动时间与临床资料的关系。结果①COPD组、吸烟组与对照组的活性纤毛细胞百分率为[（51．22±7．73）％VS（54．66±8．18）％VS（68．53±9．11）％，P〈0．05]，COPD组及吸烟组均明显低于对照组（P值均〈0．05）；纤毛摆动时间分别为[（538．45±27．17）minVS（540．68±25．61）minVS（688．52±30．56）min，P〈0．051，COPD组及吸烟组均短于对照组（P值均〈0．05），但COPD组与吸烟组之间差异无统计学意义（P〉0．05）；COPD组的活性纤毛百分率较吸烟组和正常组下降得更快（P值均〈0．01）。②相关分析：COPD组、吸烟组的纤毛摆动时间与吸烟指数呈负相关（r分别为0．5763，0．5213，P〈0．05），COPD组的纤毛摆动时间与体质量指数呈正相关（r=0．6831，P〈0．05），COPD组的纤毛摆动时间与第1秒用力呼气容积占预计值百分比（FEV1％pred）呈正相关（r=0．7090，P〈0．05）。结论COPD患者及单纯吸烟者均存在纤毛功能障碍，吸烟可能是导致纤毛功能障碍的重要原因，它在COPD发病过程中起着重要作用。COPD病情越重纤毛功能障碍可能越明显。Objective To study the relationship between cilia beat time and pulmonary function in bronchial epithelia of smokers with normal pulmonary function and patients with chronic obstructive pulmonary disease（COPD）. Methods We got tissue samples from surgical resection, the patients were allocated into group NS（nonsmokers with normal lung function）, group S（smokers with normal lung function） ,group COPD（smokers with stable COPD）,with 10 patients in each group. The percentage of active ciliated cells and cilia beat time was counted in the light microscope,and the percentage of swing cihated cells was also counted. The clinical datas including body mass index, smoking index, and pulmonary function. The correlation of cilia beat time and clinical datas was analysed. Results （1）The percentage of active ciliated ceils in group COPD,group S and group NS was [（51.22±7.73） % vs （54.66±8.18） % vs （68.53±9. 11） %, P 〈0.05] ,the percentage of group COPD and group S was significantly lower than groupNS（ P 〈0.05）. The cilia beat time was [（538.45±27.17） min vs （510.68±25.61） rain vs （688.52 ± 30.56） min], respectively. The time of group COPD and group S was significantly shorter than group NS（ P 〈0.05）. But there was no significant difference between group COPD and group S（ P 〉 0.05）. The percentage of swing cilia in group COPD decreased more quickly than those in group NS and group S. （2）The cilia beat time of group COPD and group S showed a negative correlation with smoking index（ r =-0. 5763,-0. 5213, P 〈0.05）. The cilia beat time of group COPD was positively associated with FEV1%pred（ r =0. 6831, P 〈0.05）. There was a positive correlation between the cilia beat time and body mass index（ r = 0. 6831, P 〈 0.05）. Conclusions There existed ciliary dysfunction in COPD patients and smokers. Smoking might play a role in the ciliary dysfunction and it is vital in the pathogenesis of COPD. The more severe COPD was, the worse the ciliary dysfunct

关 键 词：纤毛 黏液-纤毛清除率 慢性阻塞性肺疾病 吸烟 

分 类 号：R563.9[医药卫生—呼吸系统]