目的探讨光镜、电镜观察三步序贯法对哮喘大鼠气道重塑激素干预模型支气管肺组织病理形态学的影响。方法模拟临床激素依赖型哮喘患者激素撤减过程,建立哮喘大鼠气道重塑激素干预模型,150只大鼠随机分为气道重塑组、地塞米松干预组、普米克令舒组、三步序贯组及正常对照组。光镜、电镜下观察各组大鼠支气管肺组织形态学改变,并测定支气管壁厚度、支气管平滑肌厚度及支气管平滑肌细胞核数量的变化。结果光镜下肺组织HE染色,各组致敏大鼠可见不同程度炎细胞浸润,三步序贯组炎症反应明显减轻;光镜下Masson三色染色,气道重塑组肺间质胶原纤维大量沉积,地塞米松干预组激素撤减过程中亦出现胶原纤维沉积增多,而三步序贯组及普米克令舒组较以上2组明显减少。支气管壁厚度,激素撤减前三步序贯组与气道重塑组相比明显减低(P<0.01),激素撤减中三步序贯组与气道重塑组、地塞米松干预组相比减低(P<0.01、P<0.05),激素撤减后三步序贯组与气道重塑组、地塞米松干预组相比均明显减低(P<0.01);支气管平滑肌厚度,激素撤减前三步序贯组与气道重塑组、地塞米松干预组相比均无差别(P>0.05),激素撤减中三步序贯组与气道重塑组、地塞米松干预组相比均减低(P<0.05),激素撤减后三步序贯组与气道重塑组、地塞米松干预组相比均明显减低(P<0.01);支气管平滑肌细胞核数量,激素撤减前三步序贯组与气道重塑组、地塞米松干预组相比减低(P<0.01、P<0.05),激素撤减中、后三步序贯组与气道重塑组、地塞米松干预组相比均明显减低(P<0.01)。电镜观察,地塞米松干预组激素撤减中、后与气道重塑组情况接近,而三步序贯组及普米克令舒组激素撤减过程中气道上皮细胞纤毛脱落情况明显改善。结论三步序贯法能够明显减轻哮喘模型大鼠支气管肺组织病理形态学方面的炎性改变,从而对气道重塑起到阻抑作用。 Objective To investigate the effects of light microscope and electron microscope on pathomorphology of bronchopulmonary tissues in asthmatic rats with airway remodeling hormone intervention model. Methods The hormone-withdrawal process in patients with clinical hormone-dependent asthma was simulated and the model of airway remodeling hormone was established in asthmatic rats. 150 rats were randomly divided into airway remodeling group, dexamethasone intervention group, pulmicort group, Three-step sequential group and normal control group. The morphological changes of bronchial lung tissue in each group were observed under light microscope and electron microscope, and the changes of bronchial wall thickness, bronchial smooth muscle thickness and bronchial smooth muscle cell nucleus number were determined. Results The lung tissue was stained with HE under the light microscope. The infiltration of inflammatory cells was observed in the sensitized rats in each group. The inflammatory reaction in the three-step sequential group was significantly reduced. Under the light microscope, Masson’s trichrome staining and airway remodeling group A large number of deposition, dexamethasone intervention group hormone withdrawal process also appeared increased collagen deposition, and three-step sequential group and Pulmicort Shu than the above two groups decreased significantly. Bronchial wall thickness and the first three steps of hormone withdrawal were significantly lower than those in the airway remodeling group (P <0.01). There was no significant difference between the three sequential groups of hormone withdrawal and the airway remodeling group and the dexamethasone intervention group (P <0.01, P <0.05). Compared with the airway remodeling group and the dexamethasone intervention group, the three-step sequential group had significantly decreased bronchial smooth muscle thickness and hormone There were no significant differences between the three sequential groups before airway remodeling and those with airway remodeling and dexamethasone (P> 0.05). The three sequential groups with airway remodeling, dexamethasone (P <0.05). Compared with the airway remodeling group and the dexamethasone intervention group, the three-step sequential group after the withdrawal of hormones significantly decreased (P <0.01); the number of bronchial smooth muscle nuclei, Compared with the airway remodeling group and the dexamethasone intervention group, the sequential group of the first three steps of withdrawal reduced (P <0.01, P <0.05) , Dexamethasone intervention group were significantly lower (P <0.01). Electron microscopy showed that dexamethasone intervention group was similar to airway remodeling group during and after the withdrawal of corticosteroids, while ciliary exfoliation of airway epithelial cells was significantly improved in the three-step sequential group and the PUMOCR group. Conclusion Three-step sequential method can significantly reduce the inflammatory changes in the pathomorphology of the bronchopulmonary tissue in the asthmatic model rats, thus inhibiting the airway remodeling.