轻度慢性阻塞性肺疾病的病理特征及其与炎性因子的相关性  

Pathological features of mild chronic obstructive pulmonary disease and their correlation with inflammatory factors

作　　者：赵术彤 丁运 李月川[1,2] 赵晓赟 耿华[3] 徐美林[1,3] ZHAO Shutong;DING Yun;LI Yuechuan;ZHAO Xiaoyun;GENG Hua;XU Meilin(Clinical School of Thoracic,Tianjin Medical University,Tianjin 300222,China;Department of Respiratory and Critical Care Medicine;Department of Pathology,Tianjin Chest Hospital)

机构地区：[1]天津医科大学胸科临床学院,300222 [2]天津市胸科医院呼吸与危重症医学科 [3]天津市胸科医院病理科

出　　处：《天津医药》2024年第6期643-647,共5页Tianjin Medical Journal

基　　金：天津市医学重点学科(呼吸病学)项目(TJYXZDXK-049A)。

摘　　要：目的 探索轻度慢性阻塞性肺疾病(COPD)患者肺组织病理特征及其与炎性因子的相关性。方法 前瞻性纳入因肺小结节行手术治疗的患者70例,分为正常组10例、轻度COPD组50例、中重度COPD组10例。肺组织分别经HE、Masson、EVG染色后评估病理改变;免疫组化染色检测肺组织平滑肌肌动蛋白(SMA)、肌动蛋白(Actin)、CD31蛋白表达;免疫组化及q PCR检测肺组织肿瘤坏死因子(TNF)-α、白细胞介素(IL)-10蛋白及mRNA水平。结果 轻度COPD肺组织可见肺泡间隔增宽,小气道扩张,血管壁轻度增厚,多见以淋巴细胞为主的炎症反应。免疫组化染色提示轻度COPD肺组织中SMA、Actin蛋白含量较正常组升高(P<0.05)。此外,轻度COPD肺组织中TNF-α的mRNA水平及TNF-α阳性率明显高于正常组,而IL-10的mRNA水平明显低于正常组(均P<0.05)。SMA、Actin与炎性因子TNF-α阳性表达呈正相关,而与IL-10阳性表达呈负相关(均P<0.05)。结论 轻度COPD肺组织主要病理改变包括以小血管平滑肌层增厚为特征的肺小血管重构和以淋巴细胞浸润为主的炎症反应,同时促炎因子TNF-α升高和抗炎因子IL-10降低与COPD病理改变相关。Objective To explore the pathological features of lung tissue in mild chronic obstructive pulmonary disease(COPD)and their association with inflammatory factors.Methods A total of 70 patients who underwent surgery for small lung nodule were prospectively included,and were divided into the normal group(n=10),the mild COPD group(n=50)and the moderate and severe COPD group(n=10).The pathological changes of lung tissue were evaluated after HE,Masson and EVG staining.The expression levels of SMA,Actin and CD31 proteins were detected by immunohistochemistry staining.Tumor necrosis factorα(TNF-α),interleukin-10(IL-10)protein and mRNA levels were detected by immunohistochemistry and qPCR.Results Pulmonary tissue in mild COPD showed widening of alveolar septum,dilation of small airways,mild thickening of blood vessel wall and inflammatory reaction dominated by lymphocyte infiltration.Immunohistochemistry staining showed that contents of SMA and Actin proteins in mild COPD lung tissue were higher than those in the normal group(P<0.05).In addition,the TNF-αmRNA and the positive rate of TNF-αin lung tissue of mild COPD were significantly higher than those in the normal group,while the IL-10 mRNA was significantly lower than that of the normal group(all P<0.05).SMA and Actin were positively correlated with the positive expression of inflammatory cytokine TNF-α,but negatively correlated with the positive expression of IL-10(all P<0.05).Conclusion The main pathological changes of lung tissue in mild COPD include small lung blood vessel remodeling ocharacterized by thickening of small blood vessel smooth muscle layer and lymphocyte-dominated inflammatory response,while the increase of pro-inflammatory factor TNF-αand decrease of anti-inflammatory factor IL-10 are associated with pathological changes of COPD.

关 键 词：肺疾病 慢性阻塞性 肌细胞 平滑肌 肌动蛋白类 肿瘤坏死因子α 白细胞介素10 

分 类 号：R563[医药卫生—呼吸系统]