摘要
本研究的目的是阐明在支气管哮喘患者的肺解剖中观察到的广泛的粘液堵塞的形成机制。我们对8例支气管哮喘患者(BA组)的肺解剖气道进行了形态学分析,并与6例慢性支气管炎患者(CB组)和4例对照组患者(control)进行了比较。石蜡切片测量如下参数:支气管腺体与支气管壁体积比例(Gland%);杯状细胞颗粒至总上皮层(杯状%);腔内黏液为黏液占位率(黏液占位率MOR);连续有杯状细胞的腔内黏液体积比(Vc/Vtol %);囊内连续有杯状细胞的粘液接触面与总腔面之比(Sc/Stot %)。BA组和CB组气道壁腺体%、杯状细胞%、MOR或炎性细胞数量均大于对照组。BA组与CB组除嗜酸性粒细胞数量(Gland% 23 +/- 3,22 +/- 3,6 +/- 2%)外,Gland%、Goblet %、MOR及炎性细胞数量均无显著差异;22 +/- 9,5 +/- 4,2 +/- 2% 10 +/- 3, 18 +/- 3 and 0.3 +/- 0.5% in MOR; 199 +/- 68, 10 +/- 3 and 2 +/- 2 cells. mm-2 in eosinophil number of the peripheral airways from Groups BA, CB and Control, respectively. In contrast, marked and significant increases were observed both in Vc/Vtot% and Sc/Stot% in Group BA compared to Groups CB and Control both in central and peripheral airways: i.e. Vc/Vtot% in the peripheral airways was 53 +/- 5, 4 +/- 3 and 0.8 +/- 0.8% from Groups BA, CB and Control, respectively (BA vs CB or BA vs Control, p < 0.01 each). These findings suggest that the continuity of goblet cells and intraluminal mucus or lack of full release of mucus, from goblet cells, is peculiar to asthmatic airways, and may contribute to the formation of mucous-plugs.