摘要
目的观察哮喘患儿气道炎症、重塑表现以及支气管上皮细胞的凋亡情况,了解小儿哮喘的病理表现。方法1997-07—2006-05,以北京儿童医院收治的18例哮喘患儿为哮喘组,17例非哮喘肺部疾病患儿为非哮喘肺部疾病组,6例因非肺部疾病死亡进行尸解的患儿为非哮喘非肺部疾病组。对哮喘和非哮喘肺部疾病组进行了支气管黏膜活检。对3组患儿均观察上皮细胞完整性、黏膜下炎症细胞浸润;Masson染色观察基底膜厚度,分别做免疫组化分析胶原Ⅲ、Caspase-3的表达,采用图像分析结果。结果非肺部疾病死亡的6例患儿支气管黏膜完整,黏膜下无炎症细胞浸润,Masson染色显示基底膜无增厚,平均厚度为(0·08±0·03)μm,上皮细胞无凋亡,平均灰度值为(197·66±15·35);在18例哮喘组中,全部支气管黏膜上皮脱落明显,部分仅剩基底层细胞,甚至基底膜裸露,18例支气管黏膜下局灶性淋巴细胞浸润,其中2例并存少量或偶见嗜酸性粒细胞浸润,Masson染色显示16例基底膜增厚,2例轻度哮喘或病程短者,基底膜不厚,基底膜平均厚度为(0·299±0·078)μm,18例上皮细胞均发生凋亡,Caspase-3表达的平均灰度值为(141·72±23·66),胶原Ⅲ广泛沉积,平均灰度值为(122·79±9·59)。在17例非哮喘肺部疾病组中,10例患儿支气管上皮细胞部分脱落,7例支气管上皮细胞完整,17例均有支气管黏膜下灶性淋巴细胞浸润,Masson染色显示7例基底膜增厚,平均基底膜厚度为(0·143±0·051)μm,部分上皮细胞发生凋亡,Caspase-3表达的平均灰度值为(184·01±18·21),胶原Ⅲ仅在7例局部表达,平均灰度值(188·56±32·81)。结论哮喘患儿存在气道炎症和气道重塑,但大多为淋巴细胞浸润而不是嗜酸性粒细胞浸润,轻度哮喘或病程短者,基底膜无明显增厚。细胞凋亡是哮喘患儿支气管上皮细胞损伤的机制。在部分非哮喘肺部疾病中,支气管上皮细胞发生脱落和凋亡、基底膜增厚,哮喘患儿的病理表现与非哮喘肺部疾病存在交叉和重叠。
Objective To investigate airway inflammation, remodeling and apoptosis of epithelium in asthmatic childhood. Methods Eighteen asthmatic children lasthmatic group）, 17 non-asthmatic children （non-asthmatic lung disease group） and 6 patients who died from non-asthmatic and non-lung disease group were recruited. Mucosa biopsy was obtained in asthmatic group and non-asthmatic lung disease group. Review the epithelium integrity, inflammation cell infiltration, basal membrane＇s thickness;collagen Ⅲ and Caspase-3 expression were analyzed. Results Bronchial epithelial cells shed in all asthmatic children. Lymphocytes infiltration was found in 17 asthmatic children, but eosinophilic infiltration was found only in 1 asthmatic child. Base membrane thickening（0. 299 ±0. 078） μm in asthmatic group was higher than that in non-asthmatic lung disease group （ 0. 143 ±0. 051 μm. Compared with non-asthmatic lung disease group （ 184. 01 ± 18.21 ）, the expression of Caspase-3 increased （ 141.72 ±23.66 ）. Collagen Ⅲ deposited （ 122. 79 ±. 9. 59 ） widely in asthmatic group. Conclusion Airway inflammation, remodeling and apoptosis of epithelium are found in asthmatic childhood. Lymphocvtes not eosinophilic cells infiltrate in most of asthmatic children.
出处
《中国实用儿科杂志》
CSCD
北大核心
2007年第8期621-623,共3页
Chinese Journal of Practical Pediatrics
关键词
哮喘
气道重塑
气道炎症
上皮细胞
凋亡
Asthma
Airway remodeling
Airway inflammation
Epithelial cells
Apoptosis
