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目的:探讨结缔组织生长因子(CTGF)在慢性阻塞性肺疾病(COPD)血管重建中的表达及意义。方法:将30例有吸烟史的男性鳞癌需要手术的患者按其肺功能结果分成二组,对照组:(肺功能正常组);COPD稳定期组:(肺功能异常组),每组15例,标本来自于癌旁的肺组织,肺血管重塑的形态学观察行HE和MASSON三色染色,行免疫组化来观察CTGF蛋白、PCNA蛋白在肺血管平滑肌中的表达。结果:(1)COPD组肺动脉管壁面积/管总面积(WA%)、管壁的胶原厚度、肺动脉平滑肌中CTGF蛋白及PCNA蛋白的表达与对照组相比差异有统计学意义。(2)CTGF与管壁面积/管总面积(WA%)、管壁的胶原厚度及血管平滑肌中PCNA表达呈正相关(,r值分别为0.81、0.68、0.86,P<0.05)。吸烟指数与管壁面积/管总面积及PCNA的表达呈正相关(r=0.73,0.99,P<0.01)。结论:单纯吸烟者即有血管重建,吸烟伴COPD者血管重建更加严重,CTGF在COPD患者肺血管中的表达较对照组高,可能参与了COPD血管重建过程。
Objective: To investigate the expression of connective tissue growth factor (CTGF) in revascularization of chronic obstructive pulmonary disease (COPD) and its significance. Methods: Thirty patients with history of smoking who had surgery were divided into two groups according to their pulmonary function. The control group (normal lung function group), stable COPD group (lung dysfunction group), 15 For example, the specimens were from the adjacent lung tissues. The morphology of pulmonary vascular remodeling was observed by HE and MASSON trichrome staining. The expression of CTGF and PCNA protein in pulmonary vascular smooth muscle was observed by immunohistochemistry. Results: (1) The pulmonary artery wall area / total tube area (WA%), the collagen wall thickness, the expression of CTGF protein and PCNA protein in pulmonary artery smooth muscle in COPD group were significantly different from those in control group. (2) There was a positive correlation between CTGF and wall area / total area (WA%), collagen thickness and PCNA expression in vascular smooth muscle (r = 0.81,0.68,0.86, P <0.05). There was a positive correlation between smoking index and wall area / total tube area and PCNA expression (r = 0.73, 0.99, P <0.01). Conclusions: The revascularization of smokers with COPD is more serious with smokers alone. The expression of CTGF in pulmonary vessels of COPD patients is higher than that of control group, which may be involved in the process of revascularization of COPD.