Brody J S, Fisher A B, Gocmen A, DuBois A B
J Clin Invest. 1970 Jun;49(6):1051-60. doi: 10.1172/JCI106321.
Lung size was evaluated with pulmonary function tests in 10 patients with acromegaly, 1 pituitary giant, and 1 patient who had acromegaly but now has hypopituitarism. In the six acromegalic men all lung volumes were increased. The average values and per cent of predicted were total lung capacity 9.1 liters. 139%; functional residual capacity 5.2 liters, 145%; vital capacity 6.0 liters, 134%; and tissue volume 1.1 liters. There was no evidence of airflow obstruction or air trapping. Anatomic dead space was increased in proportion to the large lung volumes. Lung compliance was increased, averaging 0.43 liters/cm H(2)O, but lung elastic recoil was normal. These studies show that the lung is involved in the general visceromegaly of acromegaly and that lung size increases in acromegalic men as a result of actual lung growth. Despite the large lung volumes, diffusing capacity was normal suggesting that lung growth resulted from an increase in the size rather than from an increase in the number of alveoli. In contrast to the acromegalic men, lung volumes, anatomic dead space and tissue volume were normal in four acromegalic women, suggesting that sex hormones may modify the effect of growth hormone on the lung. Lung size was large in the pituitary giant but lung volumes were normal according to predicted values based on the patient's great height. Lung volumes were normal in the one male who had been acromegalic but who has been hypopituitary for 21 yr. The role of growth hormone in normal postnatal lung growth and in the maintainance of normal lung size remains to be defined.
对10例肢端肥大症患者、1例垂体巨人症患者和1例曾患肢端肥大症但现患垂体功能减退症的患者进行了肺功能测试以评估肺大小。在6例肢端肥大症男性患者中,所有肺容积均增加。总肺容量的平均值及预测值百分比为9.1升,139%;功能残气量为5.2升,145%;肺活量为6.0升,134%;组织容积为1.1升。没有气流阻塞或气体潴留的证据。解剖无效腔随肺容积增大而增加。肺顺应性增加,平均为0.43升/厘米水柱,但肺弹性回缩正常。这些研究表明,肺参与了肢端肥大症的全身脏器肿大,肢端肥大症男性的肺大小因肺实际生长而增加。尽管肺容积大,但弥散能力正常,提示肺生长是由于肺泡大小增加而非数量增加。与肢端肥大症男性患者不同,4例肢端肥大症女性患者的肺容积、解剖无效腔和组织容积正常,提示性激素可能改变生长激素对肺的影响。垂体巨人症患者的肺大小大,但根据基于患者身高预测的数值,肺容积正常。1例曾患肢端肥大症但垂体功能减退21年的男性患者肺容积正常。生长激素在出生后正常肺生长及维持正常肺大小中的作用仍有待确定。