DESTRUCTIVE INDEX - A MEASUREMENT OF LUNG PARENCHYMAL DESTRUCTION IN SMOKERS

Publisher Website
Google Scholar
Abstract
Destruction of alveolar walls was considered to be the most important part in the definition of emphysema, yet it was never precisely defined and quantitated. A reliable microscopic technique was devised to quantitate alveolar destruction that would be both sensitive to disease and easy to perform. Using a point-count system, an index of parenchymal destruction was obtained that represented the percentage of destroyed space as a fraction of the total alveolar and duct space. This measurement was called the destructive index (DI). In the lungs of 8 nonsmokers and 23 smokers, the DI was quantitated and compared with the mean linear intercept (Lm) and with pulmonary function in smokers. Although Lm was not significantly different in the 2 groups, significant differences between the DI of smokers and nonsmokers (P < 0.005) were found. The DI correlated with FEV1 (-0.43, P < 0.05), MMEF [maximal midexpiratory flow rate] (r = -0.44, P < 0.05) and recoil pressure at 90% TLC (r = -0.61, P < 0.05) in smokers. The destructive component of emphysema was easily quantitated microscopically, occurred in smokers before dimensional changes were evident (i.e., increased Lm) and influenced lung function. The quantitation of this destruction (DI) added greatly to the microscopic definition of emphysema, complementing the informaton given by the dimensional component of emphysema (Lm).

This publication has 0 references indexed in Scilit: