THE PATHOLOGY OF ASTHMA, WITH SPECIAL REFERENCE TO CHANGES IN THE BRONCHIAL MUCOSA
THE PATHOLOGY OF ASTHMA, WITH SPECIAL REFERENCE TO CHANGES IN THE BRONCHIAL MUCOSA
复制标题
DOI：
10.1136/jcp.13.1.27
复制
发表时间：
1960-01-01
影响因子：
3.4
通讯作者：
DUNNILL, MS
中科院分区：
文献类型：
--
作者：
DUNNILL, MS
本文对20例哮喘持续状态死亡病例的病理特征进行了研究。在大体切片中，肺部未显示肺气肿，但气道中的粘液栓和塌陷的局灶性区域是突出特征。5例表现为囊性支气管扩张，其分布与塌陷的局灶性区域相似，发生在上叶与下叶一样常见。在组织学上，纤毛支气管粘膜细胞脱落明显，这是由于粘膜下层水肿液渗出所致。粘膜再生区，存在简单的复层上皮，是常见的。纤毛呼吸上皮的丧失和水肿液渗出进入支气管腔，干扰了剩余纤毛细胞的活动，被认为是哮喘中支气管分泌物清除失败的基本因素。据推测，支气管痉挛在支气管粘膜脱落或哮喘发作的发病机制中起很小或没有作用。
The pathological features of 20 cases dying in status asthmaticus have been studied. In gross sections the lungs showed no emphysema, but mucus plugs in the air passages and focal areas of collapse were outstanding features. Five cases showed cystic bronchiectasis which was of a similar distribution to the focal areas of collapse, occurring in the upper lobes as commonly as in the lower lobes. Histologically, shedding of the ciliated bronchial mucosal cells was prominent and this is attributed to a transudation of oedema fluid from the submucosa. Areas of regeneration of the mucosa, with the presence of simple stratified epithelium, were seen frequently. The loss of the ciliated respiratory epithelium and the transudation of oedema fluid into the bronchial lumen, with interference with the action of the remaining ciliated cells, are considered to be the essential factors in the failure of clearance of the bronchial secretions in asthma. It is postulated that bronchospasm plays little or no part in the shedding of the bronchial mucosa or in the pathogenesis of the asthmatic attack.