结缔组织生长因子在慢性阻塞性肺疾病血管重建中表达研究

目的:探讨结缔组织生长因子(CTGF)在慢性阻塞性肺疾病(COPD)血管重建中的表达及意义。方法:将30例有吸烟史的男性鳞癌需要手术的患者按其肺功能结果分成二组,对照组:(肺功能正常组);COPD稳定期组:(肺功能异常组),每组15例,标本来自于癌旁的肺组织,肺血管重塑的形态学观察行HE和MASSON三色染色,行免疫组化来观察CTGF蛋白、PCNA蛋白在肺血管平滑肌中的表达。结果:(1)COPD组肺动脉管壁面积/管总面积(WA%)、管壁的胶原厚度、肺动脉平滑肌中CTGF蛋白及PCNA蛋白的表达与对照组相比差异有统计学意义。(2)CTGF与管壁面积/管总面积(WA%)、管壁的胶原厚度及血管平滑肌中PCNA表达呈正相关(,r值分别为0.81、0.68、0.86,P<0.05)。吸烟指数与管壁面积/管总面积及PCNA的表达呈正相关(r=0.73,0.99,P<0.01)。结论:单纯吸烟者即有血管重建,吸烟伴COPD者血管重建更加严重,CTGF在COPD患者肺血管中的表达较对照组高,可能参与了COPD血管重建过程。

Expression of Connective Tissue Growth Factor in Pulmonary Vascular Remodeling with Chronic Obstructive Pulmonary Disease

Objective: To investigate the expression and significance of connective tissue growth factor (CTGF) in pulmonary vascular remodeling in patient with chronic obstructive pulmonary disease (COPD). Method: According to their lung function, 30 male lung carcinoma patients, who had smoking history and operation in thoracic surgery, were divided into 2 groups: control group (patients with normal lung function) and COPD stable group (patients with COPD), with 15 patients in each group. The lung specimens were obtained from adjacent noncancerous tissue. Morphmetric characteristic of the pulmonary vascular remodeling was observed by HE and Masson trichrome staining. The expression of CTGF and PCNA proteins in pulmonary muscular arteries were evaluated by immunohistochemistry methods. Results: (1) The expression of CTGF, PCNA, artery wall area / total area (WA%) and collagen thickness were increased significantly in pulmonary arteries of COPD group compared with those of the control group. (2) The expression of CTGF in smooth muscle cells was correlated with the thickness of the vessel wall, collagen and the expression of PCNA (r= 0.81, 0.68, 0.86, P<0.05).The smoking index was positively correlated with WA%, the expression of PCNA (r= 0.73,0.99, P<0.01). Conclusion: Pulmonary vascular remodeling was evident in smokers without COPD, and the remodeling became more severe in patients with COPD. The expression of CTGF protein in pulmonary vessels in COPD patients tend to be higher than in that of the control group, and it may be involved in the process of pulmonary vascular remodeling.