Gilbert R, Auchincloss J H
Department of Medicine, State University of New York Health Science Center, Syracuse.
Lung. 1989;167(1):55-61. doi: 10.1007/BF02714930.
A 25-year-old farm worker developed acute bronchopneumonia after heavy exposure to a respiratory irritant in a silo. He recovered from the acute episode but then experienced chronic dyspnea and fatigue. Pulmonary function testing showed small lung volumes with a normal ratio of 1 s forced expiratory volume/forced vital capacity (restrictive defect). This defect improved markedly with bronchodilator treatment and changed to a mixed obstructive/restrictive defect with methacholine challenge. We believe that this is an example of the reactive airways dysfunction syndrome manifested by a restrictive rather than obstructive defect. Constriction of airways at the bronchiole or alveolar duct level is the most likely cause of the syndrome.
一名25岁的农场工人在谷仓中大量接触呼吸道刺激物后患上急性支气管肺炎。他从急性发作中康复，但随后出现慢性呼吸困难和疲劳。肺功能测试显示肺容积小，1秒用力呼气量/用力肺活量比值正常（限制性缺陷）。这种缺陷在支气管扩张剂治疗后明显改善，并在乙酰甲胆碱激发试验后转变为混合性阻塞性/限制性缺陷。我们认为这是反应性气道功能障碍综合征的一个例子，表现为限制性而非阻塞性缺陷。细支气管或肺泡导管水平的气道收缩是该综合征最可能的原因。
