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1968年Hogg等首先介绍小气道疾病的概念,并把慢性阻塞性肺疾病(以下简称COPD)的气道阻塞部位和特征限定于小气道的范围。其形态学上表现为炎症,粘液或纤维化所造成的2毫米以下的小气道狭窄和闭塞。他们还介绍了小气道疾病的两种概念:即急性炎症和粘液栓子所形成的可逆性病变和小气道的纤维化、扭曲、狭窄或闭塞所形成的不可逆病变。这些发现提示了小气道疾病是COPD的一种早期病变,它可能促使空气陷坑的形成,机械性肺泡膈的破裂及远端慢性肺泡炎的发展,最后发展成为COPD。该病一旦到了后期,由于噬细胞或中性细胞蛋白酶的释放可导致肺泡弹性蛋白(elastin)的降解,继而形成肺气肿。
In 1968, Hogg et al first introduced the concept of small airway disease and limited the location and characteristics of airway obstruction in chronic obstructive pulmonary disease (hereinafter referred to as COPD) to the range of small airway. Morphologically manifested as inflammation, mucus or fibrosis caused by 2 mm below the small airway stenosis and occlusion. They also introduced two concepts of small airway disease: reversible lesions formed by acute inflammation and mucus emboli and irreversible lesions caused by fibrosis, distortions, stenosis, or occlusion of small airways. These findings suggest that small airway disease is an early lesion of COPD that may contribute to the formation of air pits, the rupture of the mechanical alveolar septum and the development of distal chronic alveolitis and eventually to COPD. Once the disease is advanced, the release of phagocytic or neutral cellular proteases leads to the degradation of elastin, which in turn leads to emphysema.