Thomashow D, Summer W R, Soin J, Wagner H N, Brown T C
Johns Hopkins Med J. 1977 Jul;141(1):1-8.
Pulmonary morphologic alterations secondary alterations secondary to intravenous drug abuse have been previously identified by histopathologic study of autopsy and biopsy material. Recent investigative efforts have been directed toward defining functional abnormalities that would allow for early clinical diagnosis. For this reason, 12 asymptomatic addicts were studied with roentgenography, spirometry, single breath diffusing capacity (DLco), 99Tc perfusion and 133 Xe ventilation scanning. Nine of the twelve were heavy cigarette smokers. None reported historical evidence of chronic bronchitis or right-sided endocarditis. The DLco was the only significant routine pulmonary function abnormality (p less than .001) observed in these patients. The DLco was significantly reduced even after correction for smoking habits (p less than .001). The decrease in DLco correlated with the number of perfusion defects detected by 99Tc scanning (r = -.560). There was no correlation between DLco and the number of defects on the 133Xe ventilation scan, age, pack-years smoked, or other routine pulmonary function tests. Further, there was no correlation between the number of perfusion and the number of ventilation defects. The data suggest that the decrease in DLco found in these addicts is the result of reduction of the pulmonary capillary bed secondary to vascular or interstitial granulomatosis.
静脉药物滥用继发的肺部形态学改变先前已通过尸检和活检材料的组织病理学研究得以确认。最近的研究工作致力于确定可实现早期临床诊断的功能异常。因此，对12名无症状成瘾者进行了X线摄影、肺量计检查、单次呼吸弥散容量（DLco）、99Tc灌注和133Xe通气扫描。12人中有9人是重度吸烟者。无人报告有慢性支气管炎或右侧心内膜炎的病史证据。DLco是这些患者中观察到的唯一显著的常规肺功能异常（p<0.001）。即使校正吸烟习惯后，DLco仍显著降低（p<0.001）。DLco的降低与99Tc扫描检测到的灌注缺损数量相关（r = -0.560）。DLco与133Xe通气扫描上的缺损数量、年龄、吸烟包年数或其他常规肺功能检查之间均无相关性。此外，灌注缺损数量与通气缺损数量之间也无相关性。数据表明，这些成瘾者中DLco的降低是血管或间质肉芽肿继发肺毛细血管床减少的结果。
