放射線肺炎発症過程に伴う肺サーファクタント蛋白質A代謝の変調とその診断的意義

概要

論文の詳細を見る
Radiation pneumonitis (RP) is a serious disorder caused by radiation therapy, for the detection of which there exists no simple and sensitive clinical examination. In this study, we examined whether the measurement of serum pulmonary surfactant protein A (SP-A) levels could be effective for detecting the onset of RP. Of the 18 patients included in the study, 9 suffered RP complication after radiation therapy. Serum SP-A levels in patients with RP (64.1±6.5 ng/ml) were 1.82 times as high as those of pre-radiation (36.2±4.0 ng/ml). The difference between them was significant (p=0.0003), while the SP-A value in patients without RP after radiation therapy was almost the same as the pre radiation level. To study the mechanisms of these elevations, we developed a model of whole lung irradiation (20Gy) in adult rats. Prior to alveolitis, which was a histological change seen at day 28, levels of SP-A in lung tissue homogenates and bronchoalveolar lavage fluid had become elevated by day 21. Serum SP-A levels in the irradiated rats were significantly elevated by day 21, peaking at day 35, and then declined. Hydroxyproline contents in lung tissues were elevated by day 42 and remained so through day 56. Therefore, the increase in serum SP-A level may be reflected by alveolitis but not fibrosis. In conclusion, determination of serum SP-A could be helpful in detecting the onset of RP.
札幌医科大学の論文
1999-12-01