吸烟引起肺细小动脉病理改变的图像定量分析

来源 :心肺血管病杂志 | 被引量 : 0次 | 上传用户:ljc1007
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为更深层次的了解吸烟对肺细小动脉的影响,在原600例肺标本中,按年龄及吸烟指数分成21分组的观察基础上,每分组不加选择地取4例,共84例,每例2张切片,用图像分析仪测试切片中,所有的较圆整的<200μm肺细小动脉。测试5个指标:血管腔面积、总面积、壁面积和外径及壁厚。经计算机处理:腔面积/总面积(EA/TA)、壁面积/总面积(WA/TA)、壁厚/外径(WD/TD)三个相对比值。经统计学处理,结果EA/TA、WA/TA、WD/TD经F及Q检验,两两比较,轻度吸烟与不吸烟组年龄组比无明显差异(P>0.05);而中度吸烟以后与不吸烟、轻度吸烟各相应年龄组比有非常显著的差异(P<0.01)。且在41岁组以后60 ̄200μm肺细动脉和51岁以后<60μm肺细动脉差异更显。表明吸烟量对血管刺激随年龄的增长而增强,虽然各组中因年龄增长血管改变有所增加,但无显著性差异。这些阻力型肺细小动脉壁增厚是肺动脉高压形态学基础,持续加大可使血供发生改变,影响气体交换和血液动力学及血液流变学改变,从而右心负荷加重,可导致肺心病。对于40岁以后吸烟者应予戒烟。 For a deeper understanding of the impact of smoking on the pulmonary arterioles, in the original 600 cases of lung specimens, according to age and smoking index was divided into 21 groups on the basis of observation, each group indiscriminately to take 4 cases, a total of 84 cases, each 2 Slices were taken and all of the more rounded <200 [mu] m pulmonary arterioles were sectioned with an image analyzer. Test five indicators: vascular lumen area, total area, wall area and outer diameter and wall thickness. The computer processing: cavity area / total area (EA / TA), wall area / total area (WA / TA), wall thickness / diameter (WD / TD) three relative ratio. After statistical analysis, the results of EA / TA, WA / TA, WD / TD by F and Q test, pairwise comparison, mild smoking and non-smoking group age group no significant difference (P> 0.05) There was a significant difference (P <0.01) between smoking and non-smoking and mild smoking among the corresponding age groups. And in the 41-year-old group after 60 ~ 200μm pulmonary arterioles and 51-year-old <60μm pulmonary arterioles even more significant difference. That smoking on vascular irritation increased with age, although in each group due to age increased vascular changes, but no significant difference. These resistance-type pulmonary arterial wall thickening is the morphological basis of pulmonary hypertension, continue to increase blood supply can change, affecting gas exchange and hemodynamic and hemorheological changes, so that right heart load increased, can lead to pulmonary heart disease . For 40-year-old smokers should quit smoking.
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