The Pathological Changes Of Visceral Pleura In Chronic Obstructive Pulmonary Disease Patients

Objective: To observe the pathological change of visceral pleura in chronic obstructive pulmonary disease(COPD)patients,and to discuss the relationship between the changes and COPD airflow limitation.Methods: A total of 70 patients received the pulmonary lobectomy or partial resection because of lung tumor in Tianjin Chest Hospital from May 2014 to August 2015.According to the results of pulmonary function test,the patients were divided into COPD group [forced expiratory volume in one second(FEV1)/ forced vital capacity(FVC)<70%,n=40] and control group(FEV1/FVC?70%,n=30).The patients in COPD group were divided into mild COPD group(FEV1%pre?80%,n=21)and moderate-severe COPD(FEV1%pre<80%,n=19).The lung tissues which were not the lesion areas were used to make tissue sections.The hematoxylin-eosin(HE)and elastica van gieson(EVG)methods were used to stain the sections.The thickness of visceral pleural and the proportion of elastic fiber in visceral pleural between the two groups were observed and calculated under a microscope.Results: 1.In both COPD group and control group,visceral pleural thickness of upper and middle lobe was significantly thinner than lower lobe(P < 0.05),but the proportion of elastic fiber in visceral pleural of upper,middle lobe showed no statistical difference with the lower lobe(P>0.05).2.The visceral pleural thickness and the proportion of elastic fiber in visceral pleural of COPD group was significantly thinner than those of control group(P < 0.01).3.The visceral pleural thickness and the proportion of elastic fiber in visceral pleural of moderate-severe COPD group was significantly thinner than those of mild COPD group(P < 0.05).Conclusion : 1.Visceral pleural thickness of upper and middle lobe was thinner than lower lobe.2.The visceral pleural thickness and the proportion of elastic fiber in visceral pleural of COPD group was thinner than those of control group.3.The thinner visceral pleural and the reduction of elastic fiber in visceral pleural probably is one of the causes of expiratory airflow limitation in COPD patients.