【摘要】：研究目的:觀察慢性阻塞性肺疾病(COPD)患者臟層胸膜的病理改變,以及該改變與COPD氣流受限的關(guān)系。研究方法:選取2014年5月—2015年8月于天津市胸科醫(yī)院胸外科因肺部腫物,行全肺葉或部分肺葉切除手術(shù)患者70例。根據(jù)患者肺功能檢查結(jié)果分為COPD組[吸入支氣管舒張劑后,第一秒用力呼氣容積(FEV1)/用力肺活量(FVC)70%,40例]與對照組(FEV1/FVC≥70%,30例)。并在COPD組內(nèi)根據(jù)FEV1/FEV1預(yù)計(jì)值(FEV1%pre)對COPD組患者進(jìn)行嚴(yán)重程度分級,并根據(jù)嚴(yán)重程度再次分組。FEV1%pre≥80%為輕度COPD;50%≤FEV1%pre80%為中度COPD;FEV1%pre50%為重度COPD。將輕度COPD患者納入輕度COPD組(21例),將中度及重度COPD患者納入中重度COPD組(19例)。對手術(shù)所獲取肺組織進(jìn)行取材(取材部位未被病變浸潤,距離病變區(qū)域2cm)、制作組織切片,使用蘇木精—伊紅染色法(HE)及彈力纖維染色法(EVG)進(jìn)行染色;顯微鏡下觀察并計(jì)算各標(biāo)本臟層胸膜的厚度及彈力纖維所占比例。研究結(jié)果:1.COPD組與對照組肺上、中葉臟層胸膜厚度均明顯小于肺下葉(P0.05)。2.COPD組臟層胸膜厚度以及臟層胸膜中彈力纖維成分所占比例均明顯小于對照組(均P0.01)。3.輕度COPD組臟層胸膜厚度以及臟層胸膜中彈力纖維所占比例均明顯大于中重度COPD組(均P0.05)。結(jié)論:1.肺上、中葉臟層胸膜厚度小于肺下葉。2.COPD患者臟層胸膜變薄,彈力纖維減少。3.COPD患者臟層胸膜變薄以及彈力纖維減少,可能是呼氣氣流受限的原因之一。
[Abstract]:Objective: To observe the pathological changes of the filthy pleura in patients with chronic obstructive pulmonary disease (COPD) and the relationship between this change and the limitation of COPD airflow. Methods: 70 cases of all pulmonary lobectomy or partial lobectomy were selected from May 2014 to August 2015 in Department of thoracic surgery, Tianjin Thoracic Hospital. The results were divided into COPD Group [after inhaled bronchodilator, the first second forced expiratory volume (FEV1) / forced vital capacity (FVC) 70%, 40 cases] and the control group (FEV1/FVC > 70%, 30 cases). In group COPD, the severity of COPD patients was classified according to the FEV1/FEV1 predicted value (FEV1%pre), and the severity was again divided into.FEV1%pre more than 80% as mild COPD. 50% < FEV1%pre80% as moderate COPD; FEV1%pre50% for severe COPD. and mild COPD patients in a mild COPD group (21 cases), and moderate and severe COPD patients were included in the moderate and severe COPD group (19 cases). The lung tissue obtained from the operation was taken from the lung tissue (the site was not infiltrated by the lesion, apart from the lesion area 2cm), and the tissue section was made, and the hematoxylin Yi Hong was used. Dyeing (HE) and elastic fiber staining (EVG), the thickness of the pleura and the proportion of elastic fibers were observed and calculated under the microscope. The results were as follows: the thickness of the pleura in the lungs of the 1.COPD group and the control group was significantly smaller than that in the lower lobe of the lung (P0.05).2.COPD group, and the elastic fiber in the pleura of the.2.COPD group. The proportion of the components was significantly smaller than that of the control group (P0.01), the thickness of the pleura in the dirty layer of the.3. COPD group and the proportion of the elastic fibers in the pleura of the dirty layer were obviously larger than those in the moderate and severe COPD group (P0.05). Conclusion: on 1. lungs, the thickness of the pleura in the middle lobe of the middle lobe is smaller than the.2.COPD in the lower lobe of the lung, and the elastic fiber reduces the visceral layer of the.3.COPD patients. Thinning of pleural membrane and decrease of elastic fibers may be one of the reasons for expiratory airflow limitation.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R563.9

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 蔡穎;李一鳴;陳紅栓;李澄;袁保鋒;翟潤亞;夏晗;;慢性阻塞性肺疾病大鼠模型氣道彈性及炎癥因子改變[J];中華臨床醫(yī)師雜志(電子版);2016年22期

2 包鶴齡;方利文;王臨虹;;1990-2014年中國40歲及以上人群慢性阻塞性肺疾病患病率Meta分析[J];中華流行病學(xué)雜志;2016年01期

3 丁寧;王勝;;慢性阻塞性肺疾病發(fā)病機(jī)制最新研究進(jìn)展[J];臨床肺科雜志;2016年01期

4 孫沛;丁毅鵬;;慢性阻塞性肺疾病危險因素及發(fā)病機(jī)理研究進(jìn)展[J];海南醫(yī)學(xué);2015年09期

5 蘭豐鈴;王勝鋒;曹衛(wèi)華;李立明;;慢性阻塞性肺疾病危險因素流行病學(xué)研究新進(jìn)展[J];中華疾病控制雜志;2014年10期

6 李久榮;高金明;;氣流受限性肺疾病的免疫學(xué)機(jī)制研究進(jìn)展[J];基礎(chǔ)醫(yī)學(xué)與臨床;2014年09期

7 張立霞;王春燕;王秀文;;Image-ProPlus圖像分析軟件在免疫組織化學(xué)定量分析中的基本應(yīng)用[J];濱州醫(yī)學(xué)院學(xué)報;2014年04期

8 張俊霞;徐金升;朱榮芳;白亞玲;張勝雷;崔立文;張慧然;周薇;;慢性腎衰竭大鼠主動脈彈性功能與血管基質(zhì)金屬蛋白酶2表達(dá)及鈣化間的關(guān)系[J];中國動脈硬化雜志;2014年02期

9 王翠茹;李玲;韓云霞;蔣玲;;慢性阻塞性肺疾病發(fā)病機(jī)制的研究進(jìn)展[J];當(dāng)代醫(yī)學(xué);2011年32期

10 鐘小寧;;對慢性阻塞性肺疾病肺血管改變的幾點(diǎn)認(rèn)識[J];中華結(jié)核和呼吸雜志;2011年04期

相關(guān)碩士學(xué)位論文 前1條

1 李冠華;COPD傳導(dǎo)性氣道的改變及其對機(jī)械通氣的影響[D];天津醫(yī)科大學(xué);2010年

，

本文編號：2143375