【摘要】 目的探讨慢性阻塞性肺疾病（ＣＯＰＤ）气道上皮细胞间粘附分子１（１ＣＡＭ１）和人类白细胞ＤＲ抗原（ＨＬＡＤＲ）表达。方法对１０例ＣＯＰＤ患者，７例支气管哮喘患者，９例慢性支气管炎患者和１０名健康自愿者气道上皮细胞进行ＩＣＡＭ１和ＨＬＡＤＲ的免疫组化检查，对上皮细胞作染色进行分类检查。结果在气道刷检所获细胞分类中，ＣＯＰＤ组中性粒细胞占０．０４，与哮喘组（０．０１）和健康组（０．０１）比较差异有显著性（Ｐ＜０．００１），ＣＯＰＤ组和慢支组的刷检上皮细胞分类中，杯状细胞分别达０．１３和０．１１，与哮喘组（０．０３）和健康组（０．０６）比较差异有显著性（Ｐ均＜０．００１）。ＣＯＰＤ组ＩＣＡＭ１阳性率为１５％，与慢支组（６％，Ｐ＜０．０５）和健康组（１．８％，Ｐ＜０．０５）比较差异有显著性，与哮喘组（９％，Ｐ＞０．０５）比较差异无显著性。其阳性表达分值与健康组（Ｐ＜０．００１）、慢支组（Ｐ＜０．０５）和哮喘组（Ｐ＜０．０５）比较差异有显著性。ＣＯＰＤ组中ＨＬＡＤＲ阳性率为６％与健康组（０．６％）比较差异有显著性（Ｐ＜０．０５），与哮喘组（２．９％）和慢支组（１．４％）比较差异无显著性。ＣＯＰＤ组ＨＬＡ?更多还原

【Abstract】 Objective To study the expression of adhesion molecules in epithelial cells from patients with COPD. Method The expression of ICAM 1 and HLA DR in airway epithelial cells from 10 COPD patients,7 asthmatic patients,9 chronic bronchitis patients, and 10 healthy volunteers was evaluated using immunohistochemistry techniques. The cells were stained and analysed microscopically. Result The percentage of neutrophils in brushing cells from COPD(0.04) were significantly higher than those from asthma(0.01) and normal subjects (0.01). More goblet cells were found in COPD (mean 0.13) and chronic bronchitis (mean 0.11) as compared with asthma (0.03) and healthy volunteers. As to the expression of ICAM 1 in COPD, the percentage of cells expressing ICAM 1(15%) significantly increased in comparison with chronic bronchitis (6.28% P <0.05),healthy volunteer(1.8%, P <0.05),and asthma (8.8%, P >0.05). The score of expression of ICAM 1 in COPD was significantly higher than those in asthma ( P <0.05), chronic bronchitis ( P <0.05) and normal subjects ( P < 0.001). As to the expression of HLA DR in COPD, the percentage of cells expressing HLA DR(5.9%) significantly increased in comparison with normal subjects (0.6% P<0.05), but there was no significant difference among COPD, asthma and chronic bronchitis . The score of expression of HLA DR in COPD was significantly higher than those in healthy volunteers ( P <0.001)、chronic bronchitis ( P <0.001) and asthma ( P <0.05). In addition, the percentage of neutrophils in brushing cells from COPD significantly correlated with the expression of ICAM 1 ( r =0.81, P <0.01). Conclusion Upregulation of ICAM 1 in epithelial cell from COPD correlates with the neutrophil infiltration in COPD. Lymphocytes are in an active state in COPD and the use of brush biopsies of the bronchial epithelium may serve as a diagnostic tool for differentiation among COPD, chronic bronchitis and asthma.更多还原