Sakai M, Kiguchi T, Suzuki S, Hitomi H, Sugiyama K, Takeda J, Kudoh K, Matsuoka T, Takatani O
Third Department of Internal Medicine, National Defence Medical College, Saitama, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1990 Jul;28(7):994-8.
A male case of Swyer-James syndrome, who had been followed for bronchiectasis for a long time, detected at age 70 and diagnosed by radiological studies was reported. The movement of his left diaphragm was impaired. Arterial oxygen tension was 68 torr while breathing room air. Pulmonary function tests showed mixed ventilatory impairment, increase of residual volume, and uneven gas distribution, but diffusing capacity was normal with the single breath method. Chest radiograph revealed hyperlucency of the left lung and the right middle lung field. In these areas, pulmonary angiography showed marked hypovascularity and diffuse vascular atrophy, and perfusion and inhalation scans also showed marked decreased perfusion and ventilation. Pulmonary hypertension was not detected by right heart catheterization. Fiberoptic bronchoscopy was performed and showed no abnormality of the left bronchial tree, and bronchography demonstrated diffuse cylindrical bronchiectasis of the left lung with no alveolar filling. He had suffered from chronic sinusitis for a long time, which might suggest that he had sinobronchitis due to congenital abnormality of the airway and this caused continuous respiratory infection, which could cause this syndrome. Including our own case, about 80 cases of Swyer-James' syndrome have been reported in Japan. But only 4 cases were above 70 years of age and all of them were male, and there has been no female cases above age 50. Males predominate over females, and in both sexes the left lung was more commonly affected than the right.
报告了一例70岁时被发现并经放射学检查确诊的Swyer-James综合征男性病例，该患者长期因支气管扩张接受随访。其左膈运动受损。在呼吸室内空气时，动脉血氧分压为68托。肺功能测试显示混合性通气障碍、残气量增加和气体分布不均，但单次呼吸法测得的弥散功能正常。胸部X线片显示左肺和右中肺野透亮度增加。在这些区域，肺血管造影显示明显的血管减少和弥漫性血管萎缩，灌注和吸入扫描也显示灌注和通气明显减少。右心导管检查未检测到肺动脉高压。进行了纤维支气管镜检查，结果显示左支气管树无异常，支气管造影显示左肺弥漫性柱状支气管扩张，无肺泡充盈。他长期患有慢性鼻窦炎，这可能提示他因气道先天性异常而患有鼻窦支气管炎，进而导致持续的呼吸道感染，引发了该综合征。包括我们自己的病例在内，日本已报告了约80例Swyer-James综合征病例。但只有4例年龄在70岁以上，且均为男性，尚无50岁以上的女性病例。男性多于女性，且两性中左肺受累比右肺更常见。
