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大量吸烟COPD患者气道纤毛超微结构和粘液-纤毛转运系统功能研究
周晓军,喻毅强,赵蓓蕾,施毅,夏锡荣,肖永营
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摘要:
目的:探讨大量吸烟的慢性阻塞性肺疾病(COPD)患者气道纤毛超微结构和粘液-纤毛转运系统功能的变化。方法:对10例大量吸烟的COPD患者和6例健康对照者经纤维支气管镜活检术取支气管粘膜标本行纤毛超微结构检查;用放射性气溶胶吸入ECT显像法测定7例大量吸烟COPD患者和7例健康对照者气道粘液-纤毛转运系统的功能。结果:患者组纤毛轴丝超微结构异常比例[(19.2±2.8)%]显著高于对照组[(11.6±2.3)%,P<0.01];粘液-纤毛转运系统的功能(右肺中央感兴趣区放射性气溶胶被清除一半需要的时间)显著下降,患者组为(1 943±629)s,对照组为(1 207±276)s,P<0.05; 并且气道纤毛超微结构异常改变和粘液-纤毛转运系统的功能变化呈显著相关(r=0.7045,P<0.05)。结论:大量吸烟和慢性气道炎症因素可使气道纤毛超微结构明显改变,粘液-纤毛转运系统的功能下降;且结构和功能改变具有一致性。
关键词:  纤毛  粘液-纤毛清除率  慢性阻塞性肺疾病  吸烟
DOI:
基金项目:
Ciliary ultrastructure and mucociliary clearance of airway in COPD patients with heavy smoking
周晓军,喻毅强,赵蓓蕾,施毅,夏锡荣,肖永营
()
Abstract:
Objective:To investigate airway ciliary ultrastructure and mucociliary clearance(MCC) in COPD patients with heavy smoking. Methods:Bronchial biopsy from 10 patients and 6 healthy volunteers during fiberoptic bronchoscopy was performed and submitted to ultrastructural study of cilia.Using Emisson Computed Tomography of radioactive particles inhalation technique,MCC of 7 cases and 7 normal control subjects was evaluated. Rusults: The percentage of axonemal ultrastructure abnormalities(AUA) was markedly higher in patients group[(19.2±2.8)%] than that in control group[(11.6±2.3)%,P<0.01]. The half time of radioactivity aerosol particles being cleared(MCC marker) in right lung center-region of interesting(C-ROI) was significantly higher in patients group[(1943±629)s]than that in control group[(1207±276)s,P<0.05].There was a significant correlation between AUA and MCC (r=0.704 5,P<0.05). Conclusion: Heavy smoking and chronic airway infection cause significant increase in airway AUA percentage and decrease in MCC of respiratory tract, and Ciliary ultrastructure is coincided with mucociliary clearance of respiratory tract.
Key words:  cilia  mucociliary clearance  chronic obstructive pulmonary disease  smoking