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首页> 外文期刊>Thorax: The Journal of the British Thoracic Society >Structure-function relationship in COPD revisited: An in vivo microscopy view
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Structure-function relationship in COPD revisited: An in vivo microscopy view

机译：重新审视COPD中的结构-功能关系：体内显微镜观察

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Background Fibred confocal fluorescence microscopy (FCFM) is a novel technology that allows the in vivo assessment and quantification during bronchoscopy of the bronchial wall elastic fibre pattern, alveolar and vessel diameters and thickness of the elastic fibre in the alveolar wall. Aims To relate these structural characteristics with lung function parameters in healthy subjects, smokers with normal spirometry and patients with chronic obstructive pulmonary disease (COPD). Methods We performed FCFM in 20 never smokers, 20 smokers with normal spirometry and 23 patients with COPD who required bronchoscopy for clinical reasons. The bronchial wall elastic fibre pattern was classified as lamellar, loose and mixed pattern, and later confirmed pathologically. Airspace dimensions and extra- Alveolar vessel diameters were measured. Lung function measurements and pulmonary CT scans were obtained in all participants. Results Patients with COPD were characterised by a significantly higher prevalence of loose fibre bronchial deposition pattern and larger alveolar diameter which correlated inversely with several lung function parameters (forced expiratory volume in 1 s (FEV1) , FEV1/forced vital capacity ratio, maximum expiratory flow, carbon monoxide transfer factor and carbon monoxide transfer coefficient; p<0.05). Increased alveolar macrophages were demonstrated in active smokers with or without COPD. Conclusions This is the first FCFM study to describe in vivo microscopic changes in the airways and alveoli of patients with COPD that are related to lung function impairment. These findings open the possibility of assessing the in vivo effects of therapeutic interventions for COPD in future studies.
机译：背景技术纤维共聚焦荧光显微术（FCFM）是一种新颖的技术，可在支气管镜检查过程中对支气管壁弹性纤维的形态，肺泡和血管直径以及肺泡壁中弹性纤维的厚度进行体内评估和定量。目的将这些结构特征与健康受试者，肺量计正常的吸烟者和慢性阻塞性肺疾病（COPD）患者的肺功能参数联系起来。方法我们对20名从不吸烟者，20名肺活量正常的吸烟者和23名因临床原因需要支气管镜检查的COPD患者进行了FCFM。支气管壁弹性纤维图案被分类为片状，疏松和混合图案，随后在病理上得到证实。测量了空域尺寸和肺泡外血管直径。所有参与者均进行了肺功能测量和肺部CT扫描。结果慢性阻塞性肺病患者的特征是其纤维支气管的疏松程度明显增加，肺泡直径较大，这与多个肺功能参数呈负相关（1秒内呼气量（FEV1），FEV1 /强迫肺活量比，最大呼气流量） ，一氧化碳转移因子和一氧化碳转移系数; p <0.05）。在有或没有COPD的活跃吸烟者中，肺泡巨噬细胞增多。结论这是第一个描述体内COPD患者气道和肺泡微观变化与肺功能损害相关的FCFM研究。这些发现为在将来的研究中评估COPD的治疗性干预措施的体内效果提供了可能性。

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