Healy F, Wilson A F, Fairshter R D
Chest. 1984 Apr;85(4):476-81. doi: 10.1378/chest.85.4.476.
Forty percent of 89 patients with chronic airflow obstruction (CAO) demonstrated maximum expiration flow-volume (MEFV) patterns consistent with sudden collapse or marked narrowing of large central airways. In contrast, 43 percent of the CAO patients demonstrated a curvilinear (C) pattern; the remainder (17 percent) were intermediate. Volume displacement plethysmography indicated that the airway collapse (AC) pattern was influenced by, but was not solely, a gas compression artifact. Airway collapse patients had more obstruction and hyperinflation than C patients and also had decreased diffusing capacity, absence of density dependence, reduced lung recoil, and no effort dependence of airflow. Bronchodilator administration in AC patients typically produced large reduction of residual volume and increase of vital capacity, with a smaller increase of airflow. These data suggest that AC patients have significant, partially reversible peripheral airways obstruction plus emphysema. Possible determinants of AC include reduced central airway support, increased peripheral resistance, loss of lung recoil, and increased pleural pressures during forced expiration. The MEFV contour appears to evolve from normal to curvilinear to the AC pattern as the severity of airflow obstruction worsens.
89例慢性气流阻塞（CAO）患者中，40%表现出最大呼气流量-容积（MEFV）模式，与大气道突然塌陷或明显狭窄一致。相比之下，43%的CAO患者表现出曲线（C）模式；其余（17%）为中间模式。容量置换体积描记法表明，气道塌陷（AC）模式受气体压缩伪影影响，但并非完全如此。气道塌陷患者比C模式患者有更多的阻塞和肺过度充气，并且弥散能力降低、无密度依赖性、肺回缩力降低且气流无用力依赖性。给AC模式患者使用支气管扩张剂通常会使残气量大幅减少、肺活量增加，而气流增加较小。这些数据表明，AC模式患者存在显著的、部分可逆的外周气道阻塞合并肺气肿。AC模式的可能决定因素包括中央气道支撑减少、外周阻力增加、肺回缩力丧失以及用力呼气时胸膜压力增加。随着气流阻塞严重程度的加重，MEFV曲线似乎从正常演变为曲线模式再到AC模式。
