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目的 探讨肺结节病的肺泡Ⅱ型细胞CD4 4的表达与其发病机制的关系。方法 对 2 1例肺结节病、5例结核病、3例Wegener肉芽肿、4例特发性肺纤维化和 8份正常肺组织行活组织检查 ,行肺泡上皮总数 (AE1 /AE3)和CD4 4的免疫组化染色。 3个显微镜高倍视野为观察范围 ,以AE1 /AE3标记阳性细胞即肺泡上皮总数为基数 ,观察肺泡上皮的CD4 4阳性细胞数、以及肺泡上皮总数和CD4 4的计数比率。结果 结节病组的肺泡上皮总数为 1 1 0± 32 ,肺泡上皮CD4 4的计数为 84± 6 ,与正常组的肺泡上皮总数 (70± 1 7)和CD4 4计数 (1 8± 4)比较 ,差异有显著性 (P <0 0 0 1 )。CD4 4阳性表达于肺泡上皮膜上 ,且以肺泡Ⅱ型细胞为主。结论 结节病时肺泡上皮细胞增多 ,伴有肺泡上皮细胞膜的CD4 4高表达 ,且以Ⅱ型细胞为主 ,此变化在结节病的炎症反应和修复过程中起着重要的作用
Objective To investigate the relationship between the expression of CD4 (superscript 4) 4 in pulmonary sarcoidosis and its pathogenesis. Methods Twenty-one cases of pulmonary sarcoidosis, 5 cases of tuberculosis, 3 cases of Wegener’s granulomatosis, 4 cases of idiopathic pulmonary fibrosis and 8 cases of normal lung tissue were biopsied. The total number of alveolar epithelium (AE1 / AE3) and CD4 4 immunohistochemical staining. The three microscopic high power fields were observed. The number of CD4 4 positive cells in the alveolar epithelium and the total count of alveolar epithelium and the CD4 4 count ratio were observed on the basis of the total number of AE1 / AE3 positive cells, ie alveolar epithelium. Results The total number of alveolar epithelium in the sarcoidosis group was 110 ± 32, the count of CD4 4 in the alveolar epithelium was 84 ± 6, which was significantly higher than that in the normal group (70 ± 1 7) and CD4 4 count (18 ± 4) The difference was significant (P <0.01). CD4 4 positive expression in the alveolar epithelial membrane, and alveolar type Ⅱ cells. CONCLUSIONS: Alveolar epithelial cells are increased in patients with sarcoidosis, accompanied by high expression of CD4 4 in the alveolar epithelial cell membrane and predominantly type Ⅱ cells, which play an important role in the inflammatory response and repair of sarcoidosis