選択的肺胞気管支造影 (SAB) による慢性閉塞性肺疾患の研究肺気腫病変

抄録

Distribution of pulmonary emphysema as determined and classified by SAB was studied in comparison with clinical and functional abnormalities in 53 cases with pulmonary emphysema.
1) The incidence and distribution of pulmonary emphysema lesions as estimated by SAB showed a tendency similar to the numerical values already reported by the postmortem findings. This indicates that a morphological diagnosis can be made antemortem.
2) Statistical difference in the age of onset between various types of pulmonary emphysema was not seen. However, centrilobular emphysema (CE) was found in every age group including a relatively young generation. Thus, CE may develop earlier than the other two types in many cases.
3) As for the involvement of inflammatory factors, there was a tendency for CRP to increase in the mixed type emphysema; Thus, a high incidence of infections during the clinical course may be surmised.
4) The mixed type emphysema showed more marked decrease in FEV₁%, and diffusing capacity of the lungs, and an even more marked frequency dependence of dynamic compliance than those in the other two groups; thus, it is presumed that prognosis of the mixed type is poor even in functional aspects.
5) Referring to the data obtained from the comparative alveolo-bronchograms of the upper and lower lung fields, SAB of lower lobe alone may be enough for detecting of the presence of pulmonary emphysema.
When the prognostic aspect is required clinically, however, radiography of upper and lower lung fields is more useful for overall diagnosis of the type of disease.