Kawakami M, Chiyotani A, Aoshiba K, Kameyama S, Kobayashi K, Sakai N, Sakamoto K, Konno K, Takizawa T
Department of Medicine 1, Tokyo Women's Medical College, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1990 Sep;28(9):1202-8.
Small airway obstruction in idiopathic interstitial pneumonia was studied in 54 cases of interstitial pneumonia accompanied by restrictive, but not obstructive impairment (%VC less than 80%, FEV1/FVC% greater than 70%). Correlation analysis of %VC showed that small airway obstruction seemed to play a role in the decrease in VC in these cases. Cases were then divided into two groups. In group A, restrictive impairment was caused by the decrease in TLC (%TLC less than 80% & %RV less than 120%) and in group B, it was caused by increase in RV (%TLC greater than 80% & %RV greater than 120). Cases of idiopathic interstitial pneumonia (IIP) were preferentially categorized into group A. Statistical comparison of the lung function measurements revealed that lung parenchyma was altered less severely whereas small airway obstruction was more advanced in group B than group A. Group B was divided into two subgroups, the subgroups of IIP cases and of the other disease cases, and the latter had a larger lung volume and more severely impaired small airway function. Furthermore, IIP cases from group A had less severely altered lung parenchyma than IIP cases from group B. Smoking habits did not seem to be related to these results. The results indicate that in most cases of interstitial pneumonia other than IIP, the lung function was characterized by small airway obstruction rather than decreased lung volume, and some cases of IIP also showed a similar trend. In addition, a long-term study of lung function was made in some cases of interstitial pneumonia and it was shown that small airway obstruction could change in severity after a time interval.
对54例伴有限制性而非阻塞性肺功能损害（%VC小于80%，FEV1/FVC%大于70%）的间质性肺炎患者进行了特发性间质性肺炎小气道阻塞的研究。对%VC进行相关性分析表明，小气道阻塞似乎在这些病例的VC降低中起作用。然后将病例分为两组。A组中，限制性肺功能损害是由TLC降低（%TLC小于80%且%RV小于120%）引起的；B组中，是由RV增加（%TLC大于80%且%RV大于120%）引起的。特发性间质性肺炎（IIP）病例优先归入A组。肺功能测量的统计学比较显示，B组肺实质改变较轻，而小气道阻塞比A组更严重。B组分为两个亚组，即IIP病例亚组和其他疾病病例亚组，后者肺容积更大，小气道功能损害更严重。此外，A组的IIP病例肺实质改变比B组的IIP病例轻。吸烟习惯似乎与这些结果无关。结果表明，在大多数非IIP的间质性肺炎病例中，肺功能的特征是小气道阻塞而非肺容积减小，一些IIP病例也表现出类似趋势。此外，对一些间质性肺炎病例进行了肺功能的长期研究，结果显示小气道阻塞的严重程度在一段时间后可能会发生变化。
