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目的 深化对哮喘小气道及肺组织病理改变的认识。方法 以卵蛋白致敏法制备哮喘豚鼠模型 ,共设 6组 :对照组、哮喘 1日组、哮喘 4日组、哮喘 14日组、氟美松组及布地奈德组。观察和比较 6组豚鼠大、小气道及肺泡区病理学改变及炎性细胞浸润情况。行支气管肺泡灌洗 ,并行细胞计数及分类。电镜观察肺泡细胞的形态。测定支气管肺泡灌洗液 (BALF)中总磷脂的含量。结果 各哮喘模型组豚鼠支气管黏膜上皮、基底膜、平滑肌增厚 ,肺泡隔较对照组显著增宽 (P <0 0 0 1) ,肺泡腔变小 ;大、小气道及肺泡区有大量嗜酸粒细胞及淋巴细胞浸润 ;BALF中细胞总数较对照组显著增多(P <0 0 1) ,早期以中性粒细胞为主 ,晚期则以嗜酸粒细胞和淋巴细胞为主 ;电镜示肺泡Ⅱ型上皮细胞肿胀、板层体排空及部分脱落 ;BALF中总磷脂含量较对照组显著降低 (P <0 0 1)。氟美松组及布地奈德组以上改变显著减轻 ,接近对照组。结论 支气管哮喘时细支气管和肺组织也广泛存在着以嗜酸粒细胞为主的炎症 ;肺泡细胞在形态学改变的同时 ,也发生着功能的改变
Objective To deepen the understanding of pathological changes of small airway and lung in asthma. Methods Asthmatic guinea pig models were established by ovalbumin sensitization. There were 6 groups: control group, asthma group on day one, asthma group on day four, asthma group on day 14, flumethasone group and budesonide group. The pathological changes and inflammatory cell infiltration in large and small airway and alveolar area of 6 guinea pigs were observed and compared. Bronchoalveolar lavage, parallel cell counting and classification. Electron microscope observation of alveolar cell morphology. Determination of total phospholipids in bronchoalveolar lavage fluid (BALF) content. Results The bronchial mucosa epithelium, basement membrane, smooth muscle thickening and alveolar septum in guinea pigs in each asthma model group were significantly wider than those in the control group (P <0.01), and the alveolar space was small. Large numbers of eosinophils Granulocytes and lymphocytes infiltration. The total number of cells in BALF was significantly higher than that in the control group (P <0.01), mainly in the early stage of neutrophil and later in the eosinophils and lymphocytes; Type epithelial cells, lamellar body emptying and partial shedding; the total phospholipid content in BALF was significantly lower than that in the control group (P <0.01). The above changes of flumethasone and budesonide groups were significantly reduced, close to the control group. Conclusion Bronchial asthma and bronchial bronchus and lung tissue are also widespread eosinophil-based inflammation; alveolar cells morphological changes at the same time, there are also functional changes