Valladarés W, Ranson-Bitker B, Mensch-Dechene J, Lockhart A
Bull Eur Physiopathol Respir. 1976 Nov-Dec;12(6):715-25.
In a series of 40 cases of lung cancer, we recorded arterial dilution curves before and after unilateral occlusion of the pulmonary artery (on the pathologic side) following injection of dye into the pulmonary arterial trunk ("arterial curves") and in the capillary wedge position ("capillary curves"). In one case, a large pulmonary collateral circulation (PCC) is obvious, i.e., the dilution curve shows the characteristic shape of an early recirculation before and a normal shape after occlusion. In three cases, the PCC is likely to exist for: 1) decreasing of the capillary curves is abnormally slow during control; 2) transit time of capillary curves is obviously longer during control; 3) the surface under the arterial curve is 9 to 20 % larger during control than during occlusion. This surface undoubtly corresponds to the first dye circulation during pulmonary artery occlusion while, during control, it is increased by the PCC inspite of the exponential shape of the decreasing slope. Therefore the dye dilution method cannot be used to calculate precisely the PCC flow. Practically, in lung cancer measurements of the cardiac flow by dye dilution curves is erroneous about once out of 10 times. This conclusion can be extended to other lung diseases where a PCC may develop.
在40例肺癌患者中，我们记录了在肺动脉主干注入染料后（“动脉曲线”）以及在毛细血管楔压位置（“毛细血管曲线”），单侧阻塞肺动脉（病变侧）前后的动脉稀释曲线。在1例患者中，明显存在较大的肺侧支循环（PCC），即稀释曲线显示出阻塞前早期再循环的特征形状以及阻塞后正常形状。在3例患者中，可能存在PCC，原因如下：1）对照期间毛细血管曲线下降异常缓慢；2）对照期间毛细血管曲线的通过时间明显更长；3）对照期间动脉曲线下的面积比阻塞期间大9%至20%。该面积无疑对应于肺动脉阻塞期间的首次染料循环，而在对照期间，尽管下降斜率呈指数形状，但由于PCC而增大。因此，染料稀释法不能精确计算PCC流量。实际上，在肺癌患者中，通过染料稀释曲线测量心输出量约每10次就有1次错误。这一结论可推广至其他可能发生PCC的肺部疾病。
