Murphy D, Pack A I, Imrie C W
Q J Med. 1980 Spring;49(194):151-63.
Respiratory Function has been measured in 14 patients with acute pancreatitis, none of whom has a previous history of cardiac or respiratory disease. Their mean age was 40 years, mean PaO2 on admission, 11 kPa, and all had normal chest radiographs at that time. Arterial hypoxia was a common development and the mean PaO2 at the time of most severe hypoxia was 8.6 kPa with the lowest individual recording 4.9 kPa. In addition to daily arterial blood gas monitoring, dynamic ventilatory tests and measurements of lung volume, transfer factor, closing volume, right to left shunts and studies of gas exchange were performed. Gas exchange and shunt measurements indicated that the major abnormality responsible for arterial hypoxia was right to left shunting. Seven patients developed radiological abnormalities, five of whom has pleural effusions. Five patients showed a mild restriction in lung volume but there were no major consistent abnormalities of dynamic ventilatory tests, transfer factor, or closing volumes. Thus small airway closure, in dependent parts of the lung and less certainly loss of surfactant are unlikely to be major factors in the aetiology of arterial hypoxia in patients with acute pancreatitis. All measurements were repeated at least three months after the acute illness. The respiratory insufficiency which occurs in this disease is possibly another variant of the adult respiratory distress syndrome.
对14例急性胰腺炎患者进行了呼吸功能检测，这些患者既往均无心脏或呼吸系统疾病史。他们的平均年龄为40岁，入院时平均动脉血氧分压（PaO2）为11kPa，当时所有患者的胸部X线片均正常。动脉血氧不足是常见的病情发展，最严重缺氧时的平均PaO2为8.6kPa，个别最低记录为4.9kPa。除每日进行动脉血气监测外，还进行了动态通气试验、肺容量测量、转移因子测量、闭合气量测量、右向左分流测量以及气体交换研究。气体交换和分流测量表明，导致动脉血氧不足的主要异常是右向左分流。7例患者出现了放射学异常，其中5例有胸腔积液。5例患者肺容量有轻度受限，但动态通气试验、转移因子或闭合气量均无明显一致的异常。因此，肺下垂部位的小气道闭合以及不太确定的表面活性物质丧失不太可能是急性胰腺炎患者动脉血氧不足病因中的主要因素。所有测量均在急性疾病至少3个月后重复进行。该疾病中出现的呼吸功能不全可能是成人呼吸窘迫综合征的另一种变体。
