关键词：肺纤维化；巨噬细胞
【摘要 】 目的 观察特发性肺纤维化的超微结构变化并探讨其发病机理。方法 选择临床上提示特发性肺纤维化的患者 9例，经支气管肺活检进行光镜和电镜观察。结果 主要的形态学改变是：光镜下为肺泡炎和纤维化。电镜观察可见： (1)I型肺泡上皮细胞变性、崩解和脱落，内皮细胞肿胀，细胞间紧密连接短小， II型肺泡上皮细胞增生，基底膜变薄和破坏； (2)肺泡巨噬细胞、间质巨噬细胞增多； (3)肥大细胞浸润并见脱颗粒现象； (4)肺泡壁电子致密物沉积； (5)肌纤维母细胞、纤维母细胞、胶原原纤维及基底膜样物质增生。结论 电镜观察可见特发性肺纤维化时肺泡上皮细胞、血管内皮细胞及基底膜均有损伤，并可见间质巨噬细胞增生，肥大细胞浸润及脱颗粒，肺泡壁电子致密物沉积。上述形态学改变对特发性肺纤维化的形成提供了一些依据。
Electron microscopicstudies on pathogenesis of idiopathic pulmonary fibrosis
TANG Xiuying, HE Bing, LI Guilian, et al
Department of ElectronMicroscopy, The First Hospital, Beijing Medical University, Beijing 100034
【 Abstract 】 Objective To observe ultrastructural changes and study thepathogenesis of idiopathic pulmonary fibrosis. Methods The clinical manifestations in 9patients with idiopathic pulmonary fibrosis were selected. Transbronchial lung biopsymaterials were obtained for light microscopic and electron microscopic examination. Results The major morphologic changeswere as follows: histologically, alveolar inflammation and interstitial fibrosis wereobserved. electron microscopic findings were: 1. alveolar type I cells were degenerated、 broken-down and desquamated,endothelial cells were swelled, with inter cellular tight junction shortened, alveolartype II cells hyperplastic, basement membrane thinned and deformed; 2. alveolarmacrophages and interstitial macrophages were hyperplastic; 3.mast cells were infiltratedand degranulated; 4.electron-dense deposits were present at alveolar wall; 5.myofibroblasts 、 fibroblasts、 collagen and basement membranelike material were hyperplastic. Conclusions Electron microscopic obser vations show that the alveolarepithelial cells, endothelial cells and basement membrane are all injured, interstitialmacrophages hyperpplasia, mast cells infiltration and degranulation, electron-densedeposits at alveolar wall are present. These morphologic changes provide basis forformation of idiopathic pulmonary fibrosis.
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