Small airway remodeling in acute respiratory distress syndrome: a study in autopsy lung tissue
Small airway remodeling in acute respiratory distress syndrome: a study in autopsy lung tissue
复制标题
DOI：
10.1186/cc9401
复制
发表时间：
2011-01-01
期刊：
影响因子：
15.1
通讯作者：
Dolhnikoff, Marisa
中科院分区：
文献类型：
--
作者：
Morales, Maina M. B.;Pires-Neto, Ruy C.;Dolhnikoff, Marisa
简介：急性呼吸窘迫综合征（ARDS）患者的气道功能障碍表现为呼气流量受限和动态过度充气。这些功能改变归因于小气道的关闭/阻塞。在急性肺损伤的实验模型中，气道形态学改变已被报道，其特征是远端气道上皮坏死和剥脱。然而，到目前为止，还没有研究关注ARDS患者肺部气道形态学的变化。本研究的目的是评估ARDS患者远端气道的结构和炎症变化。方法：我们回顾性研究了死于ARDS的受试者和死于非肺部原因的对照组的尸检肺组织。通过图像分析，我们量化了上皮变化的延伸（正常、异常和脱落上皮占上皮总长度的百分比）、细支气管炎症、气道壁厚度和远端气道细胞外基质（ECM）蛋白含量。采用Student’st检验或Mann-Whitney检验比较ARDS组和对照组之间的数据。Bonferroni调整用于多次测试。采用Pearson秩检验分析形态学和临床资料的相关性。结果：31例ARDS患者（A: PaO2/FiO(2)）
Introduction: Airway dysfunction in patients with the Acute Respiratory Distress Syndrome (ARDS) is evidenced by expiratory flow limitation and dynamic hyperinflation. These functional alterations have been attributed to closure/obstruction of small airways. Airway morphological changes have been reported in experimental models of acute lung injury, characterized by epithelial necrosis and denudation in distal airways. To date, however, no study has focused on the morphological airway changes in lungs from human subjects with ARDS. The aim of this study is to evaluate structural and inflammatory changes in distal airways in ARDS patients.Methods: We retrospectively studied autopsy lung tissue from subjects who died with ARDS and from control subjects who died of non pulmonary causes. Using image analysis, we quantified the extension of epithelial changes (normal, abnormal and denudated epithelium expressed as percentages of the total epithelium length), bronchiolar inflammation, airway wall thickness, and extracellular matrix (ECM) protein content in distal airways. The Student's t test or the Mann-Whitney test was used to compare data between the ARDS and control groups. Bonferroni adjustments were used for multiple tests. The association between morphological and clinical data was analyzed by Pearson rank test.Results: Thirty-one ARDS patients (A: PaO2/FiO(2)