【摘要】 [目的]研究煤工尘肺(CWP)肺细小动脉病变与肺心病的关系。[方法]取48例矿工尸检肺组织和12例非矿工手术标本进行了病理观察。对外径<200μm的细小动脉在光镜观察的基础上用德国Kontron公司IBAS/Ⅱ图象分析仪进行测试。[结果]尘肺组细小动脉壁增厚与对照组相比:EA/TA、WA/TA、WD/TD三项比值,Ⅰ期尘肺差异有显著性(P<0.05),ⅡⅢ期差异有非常显著性(P<0.01),ⅡⅢ期与Ⅰ期相比:60～200μm小动脉差异有显著性(P<0.05)说明CWP肺血管病变范围随尘肺病变加重而加重,CWP肺细小动脉壁尘细胞沉积及尘性纤维化是造成肺血管硬化使其顺应性降低的主要原因之一。与年龄因素相比,尘肺细小的动脉病变与粉尘破坏作用有更大关系。吸烟也不足以掩盖粉尘对血管这的损伤作用。[结论]尘性气管炎和尘斑气肿是导致煤工尘肺肺动脉高压的主要原发疾病。更多还原

【Abstract】 [Objective] To study the relationship between mini pulmonary arterial lesion and pneumocardial disease. [ Method ] Examination was performed on 48 autopsy pulmonary specimens of coal miners and 12 surgery specimens of non - coal miners. On the basis of microscopic examination, the arterioles ( outer diameter, 200μM) was tested with IBAS/ Ⅱ image analysis Apparatus made by Germany Kontron Company. [Result] Compared with the contrast group, the arteriolar wall thickening of pneumoconiosis group is: the ratios of EA/ TA, WA/TA and WD/TD were significantly different ( P < 0.05) on stage I pneumoconiosis and very significantly different ( P <0.01) on stage Ⅱ and Ⅲ pneumoconiosis. The arteriole’ s (diameter between 60 and 200μM) significantly difference between stage Ⅱ, Ⅲ and stage I illustrated the more sharpen the pneumoconiosis lesion is, the larger the CWP pulmonary vascular lesion area is. Deposit of dust cell in walls of pulmonary arteriole and dusty fibrosis in CWP was one of the main reasons that cause pulmonary sclerosis and depress the resilience. Compared with age factor the destructiveness of dust has more correlation with the lesion of pulmonary arteriolar. Smoking can’ t conceal the destructiveness of dust to the vascular walls. [Conclusion] Dust trachitis and focal emphysema were the main original diseases that cause the pulmonary hypertension.更多还原