Cosio M, Ghezzo H, Hogg J C, Corbin R, Loveland M, Dosman J, Macklem P T
N Engl J Med. 1978 Jun 8;298(23):1277-81. doi: 10.1056/NEJM197806082982303.
To examine the relation between small-airways abnormalities and specific lung functions, we performed pulmonary-function tests in 36 patients, of whom two were nonsmokers, one to three days before open-lung biopsy for localized pulmonary lesions. The primary lesion in the small airways was a progressive inflammatory reaction leading to fibrosis with connective-tissue deposition in the airway walls. Increase in disease in small airways correlated with deterioration in lung function. Lesions could be reliably detected (P less than 0.05) by tests for closing capacity, the volume at which air and helium flow ere equal (a test of airway caliber and elastic recoil), and the slope of phase III of the single-breath washout curve (which tests evenness of ventilation). These tests showed abnormalities at a time when the pathologic changes were still potentially reversible and when other tests were not appreciably changed.
为了研究小气道异常与特定肺功能之间的关系，我们在36例患者中进行了肺功能测试，其中2例为非吸烟者，在开胸肺活检前1至3天，针对局限性肺部病变进行检查。小气道的主要病变是一种进行性炎症反应，导致纤维化，并伴有气道壁结缔组织沉积。小气道疾病的增加与肺功能恶化相关。通过闭合气量测试、空气与氦气流量相等时的容积（气道管径和弹性回缩力测试）以及单次呼吸冲洗曲线第三阶段的斜率（测试通气均匀性），可以可靠地检测到病变（P小于0.05）。在病理变化仍可能可逆且其他测试无明显变化时，这些测试就显示出了异常。
