珪肺患者における肺気腫合併と血清α₁-アンチトリプシン値について

抄録

Although silicosis is characterized by proliferation of fibrous tissues in the lung, it is well known that some of the patients with silicosis show emphysematous changes in the lung. To confirm the relationship between the low serum antiprotease activity and the relatively high incidence of emphysema combined with silicosis, the serum alpha-1-antitrypsin level was measured in 79 patients with silicosis, (there were none with silicotuberculosis), using Eriksson's trypsin inhibition method and the single radial immunodiffusion method. The results were discussed by comparing with chest X-ray findings and data of pulmonary function tests.
Of the 79 patients with silicosis examined, 5 showed a low serum alpha-1-antitrypsin level below normal range in both methods. However, all of the 5 patients showed an intermediate level of alpha-1-antitrypsin. Cases suggesting homozygous alpha-1-antitrypsin deficiency were not recognized in our study.
The average age of the patients with low and normal alpha-1-antitrysin on initial admission to the hospital was 44 and 53 years respectively, the difference being significant.
Roentgenological examination of the chest showed the patients with low serum alpha-1-antitrypsin exhibited emphysematous changes more frequently than the patients with normal alpha-1-antitrypsin level.
According to the respiratory function tests, the patients with low antitrypsin had a higher incidence of lowered FEV 1.0% and of elevated %RV than the normal alpha-1-antitrypsin group.
From these results, it was proved that the low serum alpha-1-antitrypsin level in silicotic patients was more closely associated with combined emphysema than the normal alpha-1-antitrypsin level.