Evander E, Arborelius M, Jonson B, Simonsson B G, Svensson G
Eur J Respir Dis Suppl. 1983;127:137-43.
Previous studies of immotile cilia syndrome have shown airway obstruction. The aim of this study was to analyse lung function in such patients before severe chronic obstruction had occurred. Spirometry, lung volumes, pulmonary resistance and static pressure volume diagram were studied in six patients (ages 21-43 years). Closing capacity, the volume of trapped gas and the slope of the alveolar plateau were determined with N2 wash-out tests. Regional ventilation was studied with a gamma camera after inhalation of 99Tcm-tagged dry aerosol. Arterial blood gases were determined at rest and during exercise. Bronchial reactivity was studied with FEV1 before and after inhalation of methacholine aerosol. Five of six patients showed a rather uniform pattern, dominated by signs of "small airway disease" seen in e.g. volumes of trapped gas and closing capacity. Those five patients had uneven ventilation scintiscans and bronchial hyperreactivity. Spirometric findings and lung mechanics were influenced by lung resection, scoliosis and by the lability of bronchial tone. Five patients had normal arterial blood gases at maximum work load. Working capacity was essentially normal in all but one patient, who had a high degree of obstruction. Immotile cilia syndrome is thus compatible with a comparatively well preserved lung function and a normal working capacity far into adult life.
以往对不动纤毛综合征的研究显示存在气道阻塞。本研究的目的是分析此类患者在严重慢性阻塞发生之前的肺功能。对6例患者(年龄21 - 43岁)进行了肺活量测定、肺容积测定、肺阻力测定及静态压力容积图检查。通过氮洗脱试验测定闭合容量、潴留气体量及肺泡平台斜率。吸入99锝标记的干气溶胶后,用γ相机研究局部通气情况。在静息和运动时测定动脉血气。吸入乙酰甲胆碱气雾剂前后用第1秒用力呼气量研究支气管反应性。6例患者中有5例表现出相当一致的模式,主要表现为“小气道疾病”的征象,如潴留气体量和闭合容量所见。这5例患者通气闪烁扫描不均匀且有支气管高反应性。肺活量测定结果和肺力学受肺切除、脊柱侧弯及支气管张力不稳定的影响。5例患者在最大工作负荷时动脉血气正常。除1例有高度阻塞的患者外,所有患者的工作能力基本正常。因此,不动纤毛综合征在成年后很长一段时间内与相对良好的肺功能和正常的工作能力是相容的。