Yamamoto T, Kawai M
Department of Neurology, Shimoshizu National Hospital.
Rinsho Shinkeigaku. 1994 Jun;34(6):552-6.
We retrospectively studied an incidence and clinical features of spontaneous pneumothorax (SPT) in Duchenne muscular Dystrophy (DMD) from chest roentgenograms and clinical records of our 50 inpatients, comparing those in severely mentally and physically disabled patients. Nine out of 50 (18%) DMD patients experienced SPT, and their chest roentgenograms showed no evidence of underlying pulmonary disease such as bulla, bleb, pneumonia. They were all asymptomatic. Clinical course was well, however, relapse occurred in 4 cases. The onset age was 20 or more in 7 patients (78%), and the incidence of SPT in patients aged 20 or more was 31%, which was 7.4 times higher than that of younger patients. Body weight at the onset of SPT was all below 30 kg, tended to be lower than that of SPT negative cases. Some patients experienced SPT after having lost their weight. SPT occurred much more frequently on the right side (right only, 7 cases; left only, 0; bilateral, 2 cases). Thoracic deformity and artificial ventilation were not major risk factors. We examined chest roentgenograms of 41 severely mentally and physically disabled inpatients, age, sex, and body weight matched and found no SPT. We conclude that SPT is frequent and asymptomatic in DMD and the major risk factors of SPT are age (above 20 years old) and body weight (below 30 kg), while thoracic deformity, and artificial ventilation are not essential.
我们通过对50例住院患者的胸部X线片和临床记录进行回顾性研究,分析杜氏肌营养不良症(DMD)患者自发性气胸(SPT)的发生率及临床特征,并与严重精神和身体残疾患者进行比较。50例DMD患者中有9例(18%)发生SPT,其胸部X线片未显示潜在肺部疾病迹象,如肺大疱、肺小疱、肺炎等。他们均无明显症状。临床过程良好,但有4例复发。7例患者(78%)发病年龄在20岁及以上,20岁及以上患者SPT发生率为31%,是年轻患者的7.4倍。SPT发病时体重均低于30kg,且往往低于未发生SPT的病例。部分患者体重减轻后发生SPT。SPT更常发生于右侧(仅右侧7例;仅左侧0例;双侧2例)。胸廓畸形和人工通气并非主要危险因素。我们检查了41例年龄、性别和体重匹配的严重精神和身体残疾住院患者的胸部X线片,未发现SPT。我们得出结论,DMD患者中SPT较为常见且无症状,SPT的主要危险因素是年龄(20岁以上)和体重(低于30kg),而胸廓畸形和人工通气并非关键因素。