Suenaga N, Nakamura H, Shiratsuki N, Nishioka Y, Kitada O, Sugita M
Fifth Department of Internal Medicine, Hyogo College of Medicine.
Nihon Kyobu Shikkan Gakkai Zasshi. 1993 Mar;31(3):296-302.
Continuous changes of respiratory impedance by the oscillation method using Asthograph and 81mKr ventilation image during saline and sulpyrine solution (100 mg/ml, 250 mg/ml) provocation were simultaneously measured in 15 adult asthmatics and 7 normal individuals. Estimation of airway obstruction by respiratory impedance using Asthograph was difficult during sulpyrine inhalation, since respiratory impedance increased gradually. In addition to the measurement of respiratory impedance, images of 81mKr ventilation were also obtained to estimate the regional ventilatory distribution. Estimation of the airway obstruction was easily obtained. Another advantage of 81mKr ventilation image is that it can estimate the regional ventilatory distribution. The site of airway obstruction provoked by sulpyrine was observed predominantly in the lower lung field. The results of our present study were as follows. 1) In 3 patient, increase of respiratory impedance and defect of 81mKr ventilation image were observed. Two cases in this group were clinically diagnosed as having aspirin-induced asthma. 2) In 7 patients, a defect of 81mKr ventilation image was observed, but no increase of respiratory impedance was observed. Five cases in this group could not be clinically diagnosed as having aspirin-induced asthma. 3) In 5 patients, neither defect of 81mKr ventilation image nor increase of respiratory impedance could be detected. These results suggest that 81mKr ventilation image on sulpyrine inhalation challenge test is a useful method for evaluating regional ventilatory distribution, but should be further investigated for application to aspirin-induced asthma.
在15名成年哮喘患者和7名正常个体中，同时使用哮喘记录仪（Asthograph）通过振荡法以及81m氪通气图像，测量了在盐水和舒必利溶液（100mg/ml、250mg/ml）激发试验期间呼吸阻抗的持续变化。在吸入舒必利期间，由于呼吸阻抗逐渐增加，使用哮喘记录仪通过呼吸阻抗来估计气道阻塞较为困难。除了测量呼吸阻抗外，还获得了81m氪通气图像以评估局部通气分布。气道阻塞的估计很容易得出。81m氪通气图像的另一个优点是它可以评估局部通气分布。舒必利诱发的气道阻塞部位主要在肺下野观察到。我们目前的研究结果如下。1）在3例患者中，观察到呼吸阻抗增加和81m氪通气图像缺损。该组中的2例临床诊断为阿司匹林诱发哮喘。2）在7例患者中，观察到81m氪通气图像缺损，但未观察到呼吸阻抗增加。该组中的5例不能临床诊断为阿司匹林诱发哮喘。3）在5例患者中，未检测到81m氪通气图像缺损或呼吸阻抗增加。这些结果表明，吸入舒必利激发试验中的81m氪通气图像是评估局部通气分布的一种有用方法，但应用于阿司匹林诱发哮喘还需进一步研究。
