中国全科医学
中國全科醫學
중국전과의학
CHINESE GENERAL PRACTICE
2014年
36期
4298-4300,4301
,共4页
张馨文%丛金鹏%董蕾%于文成
張馨文%叢金鵬%董蕾%于文成
장형문%총금붕%동뢰%우문성
肺疾病,慢性阻塞性%Toll样受体4%骨形成蛋白2%血管重塑
肺疾病,慢性阻塞性%Toll樣受體4%骨形成蛋白2%血管重塑
폐질병,만성조새성%Toll양수체4%골형성단백2%혈관중소
Pulmonary disease,chronic obstructive%Toll-like receptor 4%Bone morphogenetic protein 2%Vascu-lar remodeling
目的：探讨肺血管中Toll样受体4（TLR-4）及骨形成蛋白2（BMP-2）的表达在慢性阻塞性肺疾病（ COPD）患者血管重塑中的作用。方法肺组织标本取自青岛大学医学院附属医院胸外科2012年7月—2013年7月住院需要手术治疗的50例男性高分化肺鳞癌患者。根据是否患有COPD将患者分为COPD组和对照组，各25例。光学显微镜下观察肺动脉形态结构变化；采用图像分析系统测定管壁厚度占外径百分比（ WT%）和血管壁横断面积占血管总面积百分比（ WA%）；免疫组化染色法检测肺动脉血管平滑肌细胞TLR-4、BMP-2、增殖细胞核抗原（ PCNA）表达水平，并分析其与血管重塑的相关性。结果 COPD组患者炎症评分、WT%、WA%及肺动脉血管平滑肌细胞TLR-4、BMP-2、PCNA表达水平均高于对照组（P<0.05）。COPD组患者肺动脉平滑肌细胞TLR-4、BMP-2水平与炎症评分、WT%、WA%及PCNA水平均呈正相关，PCNA水平与WT%、WA%、炎症评分均呈正相关（ P<0.05）。结论TLR-4、BMP-2的表达水平增加促进了炎性反应，诱导平滑肌细胞增殖，在COPD患者血管重塑过程中起到了重要作用。
目的：探討肺血管中Toll樣受體4（TLR-4）及骨形成蛋白2（BMP-2）的錶達在慢性阻塞性肺疾病（ COPD）患者血管重塑中的作用。方法肺組織標本取自青島大學醫學院附屬醫院胸外科2012年7月—2013年7月住院需要手術治療的50例男性高分化肺鱗癌患者。根據是否患有COPD將患者分為COPD組和對照組，各25例。光學顯微鏡下觀察肺動脈形態結構變化；採用圖像分析繫統測定管壁厚度佔外徑百分比（ WT%）和血管壁橫斷麵積佔血管總麵積百分比（ WA%）；免疫組化染色法檢測肺動脈血管平滑肌細胞TLR-4、BMP-2、增殖細胞覈抗原（ PCNA）錶達水平，併分析其與血管重塑的相關性。結果 COPD組患者炎癥評分、WT%、WA%及肺動脈血管平滑肌細胞TLR-4、BMP-2、PCNA錶達水平均高于對照組（P<0.05）。COPD組患者肺動脈平滑肌細胞TLR-4、BMP-2水平與炎癥評分、WT%、WA%及PCNA水平均呈正相關，PCNA水平與WT%、WA%、炎癥評分均呈正相關（ P<0.05）。結論TLR-4、BMP-2的錶達水平增加促進瞭炎性反應，誘導平滑肌細胞增殖，在COPD患者血管重塑過程中起到瞭重要作用。
목적：탐토폐혈관중Toll양수체4（TLR-4）급골형성단백2（BMP-2）적표체재만성조새성폐질병（ COPD）환자혈관중소중적작용。방법폐조직표본취자청도대학의학원부속의원흉외과2012년7월—2013년7월주원수요수술치료적50례남성고분화폐린암환자。근거시부환유COPD장환자분위COPD조화대조조，각25례。광학현미경하관찰폐동맥형태결구변화；채용도상분석계통측정관벽후도점외경백분비（ WT%）화혈관벽횡단면적점혈관총면적백분비（ WA%）；면역조화염색법검측폐동맥혈관평활기세포TLR-4、BMP-2、증식세포핵항원（ PCNA）표체수평，병분석기여혈관중소적상관성。결과 COPD조환자염증평분、WT%、WA%급폐동맥혈관평활기세포TLR-4、BMP-2、PCNA표체수평균고우대조조（P<0.05）。COPD조환자폐동맥평활기세포TLR-4、BMP-2수평여염증평분、WT%、WA%급PCNA수평균정정상관，PCNA수평여WT%、WA%、염증평분균정정상관（ P<0.05）。결론TLR-4、BMP-2적표체수평증가촉진료염성반응，유도평활기세포증식，재COPD환자혈관중소과정중기도료중요작용。
Objective To explore the role of the expressions of Toll-like receptor 4(TLR-4)and bone morphoge-netic protein-2(BMP-2)in pulmonary vascular remodeling in patients with chronic obstructive pulmonary disease(COPD). Methods The lung tissue samples were obtained from 50 male patients with high-differentiated lung squamous carcinoma admit-ted to the department of thoracic surgery of the Affiliated Hospital of Qingdao University Medical College from July 2012 to July 2013. All the patients needed surgery,and were divided into COPD group and control group,each group 25 cases. The morpho-logical structure of the pulmonary arterioles was observed with optical microscope;the ratio of the thickness of the wall to the ex-ternal diameter of the pulmonary arterioles( WT%)and the ratio of the area of the wall to the area of the pulmonary arterioles ( WA%) were analyzed by computer - based image analysis system;the expressions of proliferating cell nuclear antigen (PCNA),TLR-4 and BMP-2 in vascular smooth muscle cells were detected with Immunohistochemical technique,and the correlation between the expression and vascular remodeling was analyzed. Results The inflammation score,WT%,WA% and the expressions of TLR-4,BMP-2 and PCNA of the vascular smooth muscle cells in the COPD group were all higher than those of the control group(P<0. 05). In the COPD group,the expressions of TLR-4 and BMP-2 were positively correlated with the inflammation score,WT%,WA% and PCNA,and the PCNA was positively correlated with WT%,WA% and inflamma-tion score(P<0. 05). Conclusion The increased expression of TLR-4 and BMP-2 could promote the inflammation reac-tion,induce smooth muscle cell proliferation,and may be involved in the process of vascular remodeling in patients with COPD.
