Correlation between the bronchial subepithelial layer and whole airway wall thickness in patients with asthma
Correlation between the bronchial subepithelial layer and whole airway wall thickness in patients with asthma
复制标题
DOI：
10.1136/thorax.57.3.242
复制
发表时间：
2002-03-01
期刊：
影响因子：
10
通讯作者：
Adachi, M
中科院分区：
文献类型：
--
作者：
Kasahara, K;Shiba, K;Adachi, M
背景资料：支气管哮喘患者气道壁的上皮网状基底膜（Rbm）增厚，但这种增厚是否与限制气流的气道壁增厚平行尚不清楚。本研究旨在探讨支气管哮喘患者支气管Rbm增厚与气道壁增厚的相关性。方法：49例哮喘患者和18名健康对照者参加了这项研究。在口服类固醇2周和吸入β 2受体激动剂以尽量减少气道壁的可逆性变化后，测量支气管活检标本的Rbm厚度，并通过高分辨率计算机断层扫描（HRCT）评估整个气道壁厚度。通过HRCT扫描确定气道壁面积百分比（WA%;定义为（壁面积/总气道面积）x 100）和气道壁厚度百分比（WT%;定义为[（理想外径-理想管腔直径）/理想外径] x 100），以评估整个气道壁厚度。结果：哮喘患者的WA %和WT%均高于健康人，且与Rbm厚度呈显著正相关。此外，这三个指数的气道壁厚度呈负相关，预测用力呼气容积在1秒的哮喘患者的百分比。结论：这些研究结果表明，RBM增厚平行于整个气道壁增厚，可导致不可逆的气流阻塞哮喘患者。
Background: The epithelial reticular basement membrane (Rbm) of the airway wall thickens in patients with asthma, However, whether the thickening parallels whole airway wall thickening, which limits airflow, is unknown, The aim of this study was to examine the correlation between the bronchial Rbm thickening and whole airway wall thickening in asthma. In addition, the association of Rbm and whole wall thickening with airflow obstruction was examined.Methods: Forty nine patients with asthma and 18 healthy control subjects took part in the study. The Rbm thickness was measured in bronchial biopsy specimens and whole airway wall thickness was assessed with high resolution computed tomographic (HRCT) scanning after pretreatment with oral steroids for 2 weeks and inhaled beta(2) agonist to minimise reversible changes of the airway walls. The percentage airway wall area (WA%; defined as (wall area/total airway area) x 100) and percentage airway wall thickness (WT%; defined as [(ideal outer diameter - ideal luminal diameter)/ideal outer diameter] x 100) were determined from HRCT scans to assess whole airway wall thickness. Spirometric tests were also performed.Results: WA% and WT% were higher in patients with asthma than in healthy subjects, Both WA% and WT% were strongly correlated with Rbm thickness. Moreover, these three indices of airway wall thickness were inversely correlated with the percentage of predicted forced expiratory volume in 1 second in patients with asthma.Conclusions: These findings indicate that Rbm thickening parallels whole airway wall thickening which can cause irreversible airflow obstruction in patients with asthma.