Grant J L, Naylor R W, Crandell W B
Chest. 1980 Mar;77(3):446-9. doi: 10.1378/chest.77.3.446.
Experimental airway obstruction is known to cause reflex pulmonary artery constriction, but clinical documentation of reversible bronchial obstruction and vasoconstriction is rare. A soft bronchial adenoma obstructed the left main bronchus, and scans showed minimal ventilation and perfusion on the left. Gas aspirated from beyond the tumor was hypoxic. The adenoma was removed and the lung left intact by means of a skin graft in the bronchial wall. Four months later, pulmonary function was normal, and both ventilation and perfusion of the left lung were normal. Reflex pulmonary vasoconstriction resulting from alveolar hypoxia minimizes systemic hypoxemia and also minimizes alveolar tissue hypoxia in the lung itself. The reflex is seen most frequently in perfusion scans in patients with chronic airways disease. This case in important in that it documents reversal of vasoconstriction after ventilation was restored.
已知实验性气道阻塞会引起反射性肺动脉收缩，但可逆性支气管阻塞和血管收缩的临床记录却很罕见。一个软性支气管腺瘤阻塞了左主支气管，扫描显示左侧通气和灌注极少。从肿瘤远端吸出的气体是低氧的。通过支气管壁皮肤移植切除腺瘤并保留肺组织。四个月后，肺功能正常，左肺通气和灌注均正常。肺泡缺氧引起的反射性肺血管收缩可使全身低氧血症降至最低，同时也可使肺自身的肺泡组织缺氧降至最低。这种反射在慢性气道疾病患者的灌注扫描中最为常见。该病例的重要之处在于它记录了通气恢复后血管收缩的逆转情况。
