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目的：观察COPD 患者肺组织中TLR-4，IL-8，MUC5AC 的表达，并探讨其在气道炎症、气道高分泌中的作用。方法：非 COPD、COPD 组男性肺癌病人各20 例，取其肺叶切除后的外周肺组织，对肺组织标本行HE 及AB-PAS 染色，用免疫组织化学方法检测肺组织中TLR-4，IL-8，MUC5AC 的表达并分析其相关性。结果：①COPD 患者肺组织中TLR-4，IL-8，MUC5AC 表达较对照组增高(P<0.05)。TLR-4 主要在气道上皮细胞、肺巨噬细胞及血管内皮细胞表达，IL-8 在气道壁、肺泡间隔、血管壁及肺组织内浸润的单核细胞、巨噬细胞、多形核白细胞均有表达，MUC5AC 主要在气道上皮杯状细胞中表达。②TLR-4、IL-8 表达与气道炎细胞评分成正相关(P<0.05)。TLR-4 与IL-8、MUC5AC 表达成正相关(P<0.05)。结论：COPD 患者肺组织中TLR-4 高表达可能参与了 COPD 的气道炎症及气道高分泌，这可能是通过增加IL-8 与MUC5AC 的表达来实现的。

英文摘要:

Objective: To test the expression of TLR-4 in patients with chronic obstructive disease，and to explore the role of TLR4 in airway innammation and mucus hypersecretion of COPD pathogenesis．Methods: Lung specimens from patients without COPD(non- COPD group) and patients with COPD (COPD group). 20 in each group were investigated．All lung specimens was observed by HE and AB-PAS staining. The expression of TLR-4, IL-8, MUC5AC were observed by immunohistochemical staining. Results:①The expression of TLR-4，IL-8 and MUC5AC in COPD group were higher than those in control group(P<0.05). TLR-4 major express in airway epithelial cells, pulmonary macrophage and vascular endothelial cells. IL-8 express in airway walls, alveolar interval, hemal wall and mononuclear cells, macrophages, nucleation white blood cells which infiltrate in lung issue . MUC5AC mainly express in the goblet cells of airway epithelial.②TLR-4, IL-8 were positively correlated with airway inflammatory cells score( P<0.05). TLR-4 was positively correlated with IL-8and MUC5AC (P<0.05). Conclusion: The high expression of TLR-4 probably involved in airway innammation and mucus hypersecretion of COPD pathogenesis. This may be achieved by increasing the expression of IL-8 and MUC5AC.

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