気管支喘息の病態生理に関する研究

とくに肺シンチグラム上の肺局所循環動態を中心として

抄録

Various factors concerning with regional pulmonary circulation were studied in 72 asthmatic patients using pulmonary scintiscaning in asthmatic attack and non-attack. The following results were obtained.
1. In pulmonary perfusion scaning in asthmatic attack, some types of circulatory defects were seen on scintigram in all of 72 cases. It showed to exist regional disturanbces of pulmonary circulation. It was thought that was due to functional and organic change of pulmonary blood system, regional ventilative defects and other factors.
2. The circulatory defects were relative to the intensity of attack to some extent. Most of them were reversed. After abatement of attack, the circulatory defects were improved, and also with administration the defects in most cases were improved.
3. The circulatory defects were not always correlated with the findings in chest X-ray film, but the regional defects of pulmonary circulation tended to be left behind in clear pulmonary emphysema on X-ray film after abatement of attack. The findings of organic pulmonary diseases were different from the findings of asthma. Pulmonary emphysema and bronchiectasis showed some findings on scintigram, but they were not reversed.
4. The lower the functional defects (FVC, FEV 1, FEV 1%) in attack decreased, the severer the circulatory defects tended to be. But the relation with regional function could not be found.
5. The defects of circulation were uncertainly correlated with pulmonary circulation time (R-L time) and types of asthma.
6. The circulatory defects were distinctly correlated with absorptive function of bronchial wall. The regional defects of pulmonary blood flow were seen in many of the cases reduced absorptive function of bronchial wall. The facts showed that regional hypoxia caused by asthma and the secondary changes of tracheobronchial wall accompanied with it was one of the factors of the findings.
7. Many cases (97.0%) had contructed asthma under 5 years. The findings of regional circulatory defects of them were reversed. In attack they were reduced or disappeared. Some of the cases of contructing asthma above 5 years did not show the reversion. The improvement of the defects was generally decreased. The reversion tended to decrease in proportion to the length of period during contructing.