Small airway pathology is related to increased closing capacity and abnormal slope of phase III in excised human lungs.
Small airway pathology is related to increased closing capacity and abnormal slope of phase III in excised human lungs.
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小气道病理学与切除的人肺中 III 相的闭合能力增加和异常斜率有关。
DOI：
10.1164/arrd.1980.121.3.449
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发表时间：
1980
期刊：
影响因子：
--
通讯作者：
Mitchell,RS
中科院分区：
文献类型：
--
作者：
Petty,TL;Silvers,GW;Stanford,RE;Baird,MD;Mitchell,RS
从 29 个切除的人肺中获得单次呼吸氮气和静压-容积曲线。根据关闭能力的预测值将肺分为两组； “正常”肺（n = 19）具有正常的关闭能力，“异常”肺（n = 10）的关闭能力大于正常。两组之间的关闭压力（关闭能力开始时的压力）不同。异常肺组的平均闭合压（2.25 cm H2O）高于正常肺组（0.98 cm H2O）（p < 0.01）。使用分级系统来估计每个全肺小气道的病理变化程度。附壁炎症和鳞状上皮化生是小气道的 2 个病变，两组之间程度差异显着（p < 0.05）。合并两组数据以确定所检查的任何病理变量是否与单次呼吸氮曲线的数据相关。在评估的小气道病变中，只有炎症细胞浸润程度（p < 0.01；r = 0.569）和小气道平滑肌增加（p < 0.05；r = 0.379）与关闭能力增加显着相关。管腔细胞和粘液阻塞气道、壁炎症和气道肌肉增加均与 III 期或肺泡平台斜率的增加相关，以预测值的百分比表示（p < 0.03）。关闭压力和关闭能力之间也存在良好的相关性，以预测值的百分比表示（p < 0.001；r = 0.68）。我们的结论是，在切除的人肺中，关闭能力和 III 期斜率的异常增加与关闭压力的增加和小气道的病理变化有关。
Single-breath nitrogen and static pressure-volume curves were obtained from 29 excised human lungs. The lungs were separated into 2 groups based on values predicted for closing capacity; “normal” lungs (n = 19) had normal closing capacities, and “abnormal” lungs (n = 10) had closing capacities that were larger than normal. Closing pressure (the pressure at the onset of closing capacity) differed between the 2 groups. The group of abnormal lungs had a higher mean closing pressure (2.25 cm H2O) than that of the group of normal lungs (0.98 cm H2O) (p < 0.01). A grading system was used to estimate the extent of pathologic changes in the small airways of each whole lung. Mural inflammation and squamous metaplasia were 2 lesions of the small airways that differed significantly in degree (p < 0.05) between the 2 groups. Data from both groups were combined to determine whether any of the pathologic variables examined were correlated with the data from the single-breath nitrogen curves. Among the small airway lesions evaluated, only the degree of inflammatory cell infiltration (p < 0.01; r = 0.569) and increase in small airway smooth muscle (p < 0.05; r = 0.379) were significantly related to increased closing capacity. Occlusion of airways by luminal cells and mucus, mural inflammation, and increased airway muscle were all correlated with an increase in the slope of phase III, or alveolar plateau, expressed as a percentage of the predicted value, (p < 0.03). A good correlation was also found between closing pressure and closing capacity expressed as a percentage of the predicted value (p < 0.001; r = 0.68). We conclude that in excised human lungs, abnormal increases in closing capacity and slope of phase III are associated with increased closing pressure and pathologic changes in small airways.