Hughes J A, Hutchison D C, Bellamy D, Dowd D E, Ryan K C, Hugh-Jones P
Thorax. 1982 Jan;37(1):32-7. doi: 10.1136/thx.37.1.32.
Fifty-six male patients with pulmonary emphysema and normal serum alpha 1-antitrypsin were followed for a minimum period of three years (range 3-13 yr) to observe the effects of the radiological distribution of emphysema on the annual rate of change of lung function indices. The subjects were placed in three categories--upper zone (UZ), lower zone (LZ), and generalised (G). The influence of smoking was taken into account with subjects in each radiographic category being divided into ex-smokers (group EX-S) and continuing smokers (group S). The rate of decline of FEV1, VC, TCO, and KCO was greater in group S than EX-S in all three x-ray categories. In group S, FEV1, VC, TCO, and KCO declined significantly faster in UZ emphysema than in G emphysema. In group EX-S, FEV1, TCO, and PaO2 declined significantly faster in UZ than G emphysema but VC remained unaltered. KCO and PaCO2 did not change significantly in any radiographic category in either group S or EX-S. Patients with G and LZ emphysema underwent very similar physiological changes over the course of time. Those with UZ emphysema, however, complained of exertional dyspnoea at an earlier age; a number of their lung function indices deteriorated at a faster rate than in patients from the other two categories, suggesting that UZ emphysema is a different disease entity.
对56例血清α1 -抗胰蛋白酶正常的男性肺气肿患者进行了至少三年（范围3 - 13年）的随访，以观察肺气肿的放射学分布对肺功能指标年变化率的影响。将受试者分为三类——上叶区（UZ）、下叶区（LZ）和全小叶型（G）。考虑到吸烟的影响，每个放射学分类中的受试者又分为戒烟者（EX - S组）和持续吸烟者（S组）。在所有三个X线分类中，S组的第1秒用力呼气容积（FEV1）、肺活量（VC）、一氧化碳总弥散量（TCO）和一氧化碳弥散系数（KCO）的下降速率均高于EX - S组。在S组中，UZ型肺气肿患者的FEV1、VC、TCO和KCO下降速度明显快于G型肺气肿患者。在EX - S组中，UZ型肺气肿患者的FEV1、TCO和动脉血氧分压（PaO2）下降速度明显快于G型肺气肿患者，但VC保持不变。在S组和EX - S组的任何放射学分类中，KCO和动脉血二氧化碳分压（PaCO2）均无显著变化。G型和LZ型肺气肿患者在随访过程中经历了非常相似的生理变化。然而，UZ型肺气肿患者在较早年龄就出现劳力性呼吸困难；他们的一些肺功能指标恶化速度比其他两类患者更快，这表明UZ型肺气肿是一种不同的疾病实体。
