HYPERREACTIVE SITE IN THE AIRWAY TREE OF ASTHMATIC-PATIENTS REVEALED BY THICKENING OF BRONCHIAL MUSCLES - A MORPHOMETRIC STUDY
HYPERREACTIVE SITE IN THE AIRWAY TREE OF ASTHMATIC-PATIENTS REVEALED BY THICKENING OF BRONCHIAL MUSCLES - A MORPHOMETRIC STUDY
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DOI：
10.1164/ajrccm/141.5_pt_1.1327
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发表时间：
1990-05-01
期刊：
影响因子：
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通讯作者：
TANEMURA, M
中科院分区：
文献类型：
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作者：
EBINA, M;YAEGASHI, H;TANEMURA, M
假设支气管肌肉的反应性越强，它们的工作肥大就越大，我们分析了肥大平滑肌沿着气道的分布，以了解哮喘收缩主要发生在支气管树的何处。对16例支气管哮喘患者、13例其他COPD患者和20例对照者的尸检肺进行支气管肌肉形态测定。在显微镜载玻片中，从节段性支气管到终末细支气管获取气道横截面。测量基底膜周长L和肌肉血清S，计算基底膜拉伸成圆而不改变L和S的标准圆状态下的解剖半径R和肌肉厚度D。在D和R的双对数坐标上，哮喘患者的数据被合并，结果表明，肌肉肥大在最有可能发生收缩的较大支气管中最为明显。然而，对患者的进一步分析显示，除了我们指定为I型哮喘的典型模式外，还有一组患者（II型）的肥大累及整个气道，包括细支气管，这表明哮喘反应的部位在患者之间存在差异。在非哮喘性COPD患者中，尽管主要在小气道存在阻塞性病变，但仅在大气道发现轻度肌肉肥大。
Under the assumption that the more hyperreactive the bronchial muscles are, the greater their work hypertrophy, we analyzed the distribution of hypertrophic smooth muscles along airways to see where in the bronchial tree asthmatic constrictions mainly occur. Autopsy lungs from 16 patients with bronchial asthma, 13 with other COPDs, and 20 controls were submitted to morphometry of the bronchial muscles. In microscopic slides, cross sections of airways were taken from the segmental bronchi to the terminal bronchioles. The perimeter length L of the basement membrane and the sera S of muscles were measured, and the anatomic radius R and the muscular thickness D were calculated in a standardized circular state, in which the basement membrane was strecthed into a circle without changing L or S. On bilogarithmic coordinates of D and R on which data from the asthmatics were pooled, it was shown that hypertrophy of muscles was the most pronounced in larger bronchi where constriction was most likely to occur. Closer analysis of patients, however, revealed that besides this typical pattern, which we designated Type I asthma, there was a group of patients (Type II) in whom hypertrophy involved the entire range of airways, including the bronchioles, suggesting that the site of asthmatic response varies among patients. In nonasthmatic patients with COPD, only mild hypertrophy of muscles was found in the large airway, despite the presence of obstructive lesions mainly in the small airways.