The Ultra Structure Changes Of Pulmonary Small Arteries In Smokers And Patients With Chronic Obstructive Pulmonary Disease

Objective 1) The study was to investigate the character of ultra structure of pulmonary arteries in smokers and patients with chronic obstructive pulmonary disease (COPD). 2) Investigate the impact of smoking on the remodeling of pulmonary small arteries. Methods Collecting the patients who with simple peripheral lung carcinoma and need to be operated in thoracic surgery of cardiovascular institute.30 patients were divided into 3 groups with COPD or not and smoking history, each of 10 cases. Group A : non-smoking, group B: smoking but with normal pulmonary function, group C : smoking with COPD. Such items as blood gas analysis, pulmonary function, smoking index were performed in all patients before the operations. Taking the lung organization from operations, alveoli destruction and pulmonary arterial remodeling were observed by HE strains and triple strains, lumen area, arteries walls, intimal area, muscular arteries, partial muscular arteries, non partial muscular arteries were measured, and the changes in ultra structure of pulmonary small arteries have been observed. 3) Associated smoking index with the muscle arteries ratio, the Proportion of vascular and alveolar area, analysis were made.Results 1) The result of blood gas analysis group B and C is normal, but pulmonary function in group C drops. 2)Characteristics of intra- acinar pulmonary muscular arteries : Compared with group A, arteries walls of group B and C congested and swelled, inflammation cells increased, the thickness of intimal layer,walls of intra-acinar pulmonary muscular arteries of group B And C was significantly higher, the area of its lumen was narrow and the Proportion of their muscular arteries of group B and C was higher (P<0.01), most of the characteristic showed particularly obvious in group C. 3) Ultra structural changes of intra-acinar pulmonary muscular arteries: intimal layer in group A showed normal, so as endothelial cells; collagen fiber was not observed increased. Ultra structural observation of intra-acinar pulmonary muscular arteries showed degeneration and distortion of endothelial cells. The mitochondria's in the vascular endothelial cells of pulmonary small arteries observed swelling in group B, and the conjunction had been widen and basal membrane was be thicken. The organizational structure showed disordered in group C. Smooth muscle was observed irregular and fracture, collagen fibers increased, endothelial cells severely deformed. Mitochondria's in the vascular endothelial cells of pulmonary small arteries could be observed swelled too. 3) Correlation Analysis: allsmokers to smoke index and alveolar area, the pulmonary artery of the artery muscle ratio, the proportion of the muscle of the artery wall area, intimal area, positive correlations were showed (r=0.808,0.827,0.686,0.814,0.697, P<0.05) , a negative correlation was showed correlated with lumen area(r=-0.689, P<0.05) .Conclusions Smokers and smoking Patients with COPD showed the similar Characterizations in smooth muscle cells,endothelial cells and Pulmonary Arterial remodeling, which related to the smoking.