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目的 从病理学和组织化学角度观察内毒素性肺损伤时肺组织超微结构和 NOS阳性染色细胞数的变化。方法 采用电镜、还原型辅酶 - -黄递酶 (NADPH- d)组织化学技术观察兔内毒素性急性肺损伤时肺组织超微结构的改变和肺内小血管、细小支气管、肺泡的 NOS阳性染色细胞数目的变化。结果 :内毒素注射后观察 30分钟组 (I3 0′组 )与内毒素注射后观察 1周组 (Iw 组 ) ,肺内小血管、 NOS阳性染色细胞数明显增多 ,细小支气管和肺泡则减少。 I3 0′组与 Iw 组分别与 C组比较 :(小动脉 :I3 0 vs C,P<0 .0 1;Iwvs C,P<0 .0 0 1;小静脉 :I3 0 vs C,P<0 .0 1;Iw vs C,P<0 .0 5 ;细小支气管 :I3 0vs C与 Iwvs C均为 P<0 .0 2 ;肺泡 :I3 0 vs C与 Iwvs C均为 P<0 .0 1)。电镜结果显示 ,I3 0′组部分肺毛细血管内见有大量红细胞集聚 ,毛细血管内皮变薄 ,微细结构不甚清楚 ,Iw组部分毛细血管内皮细胞损伤状况较 I3 0′组更显严重 ,除较多见红细胞渗入肺泡腔外 ,尚见部分肺泡上皮结构不甚完整而呈泡状改变。结论 内毒素性肺损伤 ,肺内 NOS阳性染色细胞数在小血管明显增加 ,在支气管内 ,肺泡内则明显减少。
Objective To observe the changes of lung tissue ultrastructure and NOS positive cells in endotoxin-induced lung injury in pathology and histochemistry. Methods The ultrastructural changes of lung tissue and the NOS positive staining of small blood vessels, bronchioles and alveoli in rabbits were observed by electron microscope and reduction coenzyme - diaphorase (NADPH - d) histochemical technique. Changes in the number of cells. Results: The number of small pulmonary artery and NOS positive cells in the lungs was significantly increased in the 30 min group (I 3 0 ’group) and 1 week after the endotoxin injection (Iw group), while the number of bronchus and alveoli decreased. I3 0 ’group and Iw group were compared with that of C group: (arteriole: I3 0 vs C, P <0.01; Iwvs C, P <0.01; venule: I3 0 vs C, P < 0 .0 1; Iw vs C, P <0. 05; fine bronchus: I3 0 vs C and Iwvs C all P <0. 02; alveoli: I3 0 vs C and Iwvs C were P <0 .0 1). Electron microscopy results showed that a large number of erythrocytes were accumulated in the pulmonary capillaries of I3 0 ’group, the capillary endothelium became thinner and the microstructure was not clear. Some of the capillary endothelial cells in Iw group were damaged more severely than I3 0’ See more infiltration of red blood cells outside the alveolar space, still see part of the alveolar epithelial structure is not complete and vesicular changes. Conclusions Endotoxin-induced lung injury showed that the number of NOS-positive cells in the lung significantly increased in small vessels and significantly decreased in bronchi and alveoli.