Avital A, Shulman D L, Bar-Yishay E, Noviski N, Schachter J, Krausz Y, Godfrey S
Pulmonary Function Laboratory, Hadassah University Hospital, Jerusalem, Israel.
Thorax. 1989 Apr;44(4):298-302. doi: 10.1136/thx.44.4.298.
A previously healthy two year old boy had an adenoviral infection at the age of 13 months and developed hyperlucency of the left lung, chronic respiratory distress, and failure to thrive. Bronchodilators and steroid treatment had no effect. Radionuclide lung scans using an intravenous bolus of xenon-133 both before and after treatment showed substantially reduced function on the hyperlucent side and modestly reduced function on the other side. Fibreoptic bronchoscopy showed no structural abnormalities. Partial forced expiratory flow volume (PEFV) curves, generated from end inspiration by rapid compression of the chest wall with an inflatable jacket, were obtained from the total respiratory system and from each lung separately by inflating a Fogarty catheter in the contralateral mainstem bronchus. Expiratory flow rates and volumes during both tidal breathing and PEFV manoeuvres were considerably decreased in the hyperlucent lung. PEFV curves from the "healthy" right lung and from the total respiratory system were similar in shape and showed a moderately obstructive pattern. The right lung ventilated about four times as much as the left when measured by bronchospirometry and about three times as much when measured by the radionuclide technique. The lung scans appeared to reflect adequately the functional abnormality in this infant with the Swyer-James syndrome.
一名既往健康的两岁男孩在13个月大时感染了腺病毒，随后出现左肺透亮度增加、慢性呼吸窘迫和发育不良。支气管扩张剂和类固醇治疗均无效。治疗前后静脉注射氙-133进行放射性核素肺扫描显示，透亮度增加一侧的肺功能显著降低，另一侧肺功能略有降低。纤维支气管镜检查未发现结构异常。通过用充气夹克快速压迫胸壁从吸气末产生部分用力呼气流量容积（PEFV）曲线，通过在对侧主支气管中插入Fogarty导管分别从整个呼吸系统和每侧肺获得该曲线。在透亮度增加的肺中，潮式呼吸和PEFV操作期间的呼气流量率和容积均显著降低。来自“健康”右肺和整个呼吸系统的PEFV曲线形状相似，呈中度阻塞模式。通过支气管肺量计测量，右肺通气量约为左肺的四倍，通过放射性核素技术测量约为三倍。肺扫描似乎充分反映了这名患有斯怀尔-詹姆斯综合征婴儿的功能异常。
