Ⅱ型减压病肺组织超微结构改变  

Pulmonary ultrastructural changes in type Ⅱ decompression sickness

作　　者：李培峰[1] 刘晓红[1] 高光凯[2] 郑金峰[1] 周露婷[1] 毛蕊琪[1] 时艳辉 耿明[1] 

机构地区：[1]济南军区总医院病理科,山东济南250031 [2]解放军第401医院高压氧治疗中心,山东青岛370200

出　　处：《分子诊断与治疗杂志》2014年第3期172-176,共5页Journal of Molecular Diagnostics and Therapy

基　　金：军队医学科研"十二五"面上项目(CWS11J231)

摘　　要：目的观察兔实验型减压病肺组织超微结构改变，探讨减压病对肺组织损伤的机制。方法用雄性新西兰家兔制备减压病模型。动物出舱后30～60分钟内处死，取肺尖部组织，制备超薄切片，电镜下观察超微结构。并设安全减压组和正常组作为对照。结果减压病组：电镜下见肺泡腔部分闭塞，部分实性变，内见红细胞渗出，I型肺泡上皮细胞突起回缩，胞体肿胀，线粒体肿胀。Ⅱ型肺泡上皮细胞肿胀明显，细胞质内线粒体扩张，板层小体减少；另见部分Ⅱ型上皮细胞固缩，核染色质凝集，固缩的细胞内线粒体空泡变性，板层小体消失。毛细血管扩张充血，毛细血管内皮细胞肿胀，基底膜不完整。安全减压组：部分肺泡腔扩大，毛细血管充血，I性肺泡上皮和毛细血管内皮细胞轻度肿胀；Ⅱ型肺泡上皮线粒体轻度肿胀，溶酶体数目增多，板层小体细胞膜下聚集。结论减压病可导致呼吸上皮损伤、血气屏障破坏，影响肺泡气体交换；其机制可能与减压过程中，在血管和组织内产生的游离气泡有关。Objective To observe the ultrastructural changes of lung in rabbits with decompres- sion sickness Ⅱ （DSC Ⅱ ）, and to investigate the mechanism of lung injury in DSC Ⅱ. Methods DSC Ⅱ model was made in male New Zealand rabbits, and safe decompression group and normal group were set up as Control groups. The rabbits were killed in 30-60 minutes after leaving the hyperbaric chamber, and the apical tissue of lung was made into ultra-thin slices. The ultrastructural changes of lung were observed with transmission electron microscope. Results In DSC group, emphraxis or solid change of some alveolar space was found, where red blood cells exuded from capillaries. Retraction, cellular and mitochondrial swelling were observed in alveolar epithelial type I cells. Alveolar epithelial type Ⅱ cells were also significantly swollen, with expansion of the cytoplasm mitochondria and decreased number of lamellar bodies. Moreover, some alveolar epithelial type Ⅱ cells showed pyknotic cytoplasm, aggregation of nuclear chromatin and mitochondrial vacuolar degeneration, and lamellar bodies disappeared. Dilated capillaries were congestive, with swollen endothelial cells and incomplete basement membrane. In safe decompression group, minor changes occurred. Some enlarged alveolar space and capillary congestion were observed. The alveolar epithelial type I cells and capillary endothelial cells were mildly swollen. Alveolar epithelial type Ⅱ cells showed mild swelling of mitochondria, increase of lysosome number and gathered lamellar bodies under cell membrane. Conclusion DSC Ⅱ can result in damage of respiratory epithelium and blood-air barrier, and affect the alveolar gas exchange. Its mechanism may be related to free bubbles within vasculature or tissue produced during the decompression process.

关 键 词：减压病 超微结构 肺泡 上皮细胞 

分 类 号：R563[医药卫生—呼吸系统]