哮喘、慢性阻塞性肺疾病、ACOS患者气道重塑及气道上皮屏障的对比  

Comparison of airway remodeling and airway barrier in patients with asthma, chronic obstructive pulmonary disease and ACOS

作　　者：郭伟洪[1] 张丹丹 缪卓峰 梁剑平[1] 袁小玲[1] GUO Weihong;ZHANG Dandan;MIU Zhuofeng;LIANG Jianping;YUAN Xiaoling(Department of Respiratory Medicine,Zhongshan People's Hospital,Zhongshan 528400,China)

机构地区：[1]广东省中山市人民医院呼吸内科,广东中山528400

出　　处：《中国医药科学》2018年第11期13-16,共4页China Medicine And Pharmacy

基　　金：广东省中山市科技计划项目(2014A1FC078)

摘　　要：目的对比支气管哮喘、慢性阻塞性肺疾病及ACOS患者气道基底膜厚度及气道上皮间连接蛋白表达及分布的差异。方法收集2014年3月~2016年3月中山市人民医院呼吸科就诊的对照组15例、哮喘组14例、慢阻肺组16例及ACOS组14例患者的一般情况。所有受试者行肺功能及纤支镜下气道黏膜活检。气道黏膜活检标本行HE染色,利用光学显微镜及半自动软件测量基底膜厚度。免疫组化检测不同组别患者气道上皮细胞间E钙粘蛋白、β环连蛋白表达及分布的异同。结果哮喘组(47.25±14.38)μm及ACOS组(54.75±18.28)μm气道基底膜厚度较正常组(12.25±3.86)μm明显增厚(P<0.05)。与COPD组(23±7.78)μm相比,ACOS组基底膜厚度明显增厚,且差异有统计学意义(P<0.05);与哮喘组相比,ACOS组基底膜厚度有增加,但差异无统计学意义(P>0.05);与正常组相比,哮喘组、慢阻肺组及ACOS组气道上皮细胞间E钙粘蛋白表达均有减少、分布紊乱,但三种疾病状态下差异无统计学意义(P>0.05);各组间β环连蛋白表达差异无统计学意义(P>0.05)。结论哮喘、慢阻肺、重叠综合征患者的气道重塑程度存在明显差异,重叠综合征患者更重;气道上皮间屏障功能差异不明显。Objective To compare the differences in the thickness of the airway basement membrane and the expression and distribution of the airway epithelial connexin in the patients with bronchial asthma,chronic obstructive pulmonary disease and asthma-chronic obstructive pulmonary disease(ACOS).Methods The general situation of 15 cases in the control group,14 cases of asthma group,16 cases of chronic obstructive pulmonary disease group and 14 cases of ACOS group from March 2014 to March 2016 in respiration department of Zhongshan People's Hospital were collected.All subjects were treated with lung function and fiberoptic bronchoscopic biopsy.Airway biopsy specimens were stained with HE,and the thickness of basement membrane was measured by optical microscope and semi-automatic software.Immunohistochemical staining was used to detect the expression and distribution of E cadherin and beta catenin in airway epithelial cells of different groups.Results The thickness of airway basement membrane of asthmatic group(47.25±14.38)um and ACOS group(54.75±18.28)um was thicker than that of normal group(12.25±3.86)um(P<0.05).Compared with the COPD group(23±7.78)um,the thickness of the basement membrane in the ACOS group was significantly thicker,and the difference was statistically significant(P<0.05).Compared with the asthma group,the thickness of the basal membrane in the ACOS group was increased,but the difference was not statistically significant(P>0.05).Compared with the normal group,the expression of E cadherin in the airway epithelial cells of the asthmatic group,the chronic obstructive pulmonary disease Group and the ACOS group were reduced and disordered,but the difference in the three diseases was not significant(P>0.05).There was no significant difference in the expression of beta catenin between the groups(P>0.05).Conclusion There is a significant difference in the degree of airway remodeling in patients with asthma,chronic obstructive pulmonary disease and overlapping syndrome,and the patients with overlapping syndrome

关 键 词：哮喘 慢性阻塞性肺疾病 重叠综合征 基底膜厚度 气道上皮屏障 

分 类 号：R562.25[医药卫生—呼吸系统] R563.9[医药卫生—内科学]