後天性心疾患におけるFlow-volume曲線の拘束性肺機能障害評価上の有用性
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概要
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The flow-volume curve(F-v curve)has been used to detect obstructive changes of small airways in chronic obstructive lung disease. However, the evaluation of restrictive changes of the lung with the F-v curve has been given little attention. This study was designed to evaluate restrictive changes of the lung in heart diseases with the F-v curve. F-v curve was measured in 20 normal subjects, 20 patients with obstructive lung disease and 20 patients with restrictive lung disease. The V_50/V_25 ratio of patients with restrictive lung disease indicated a significantly higher value than that of normal subjects and the patients with obstructive lung disease, suggesting that this index was useful to detect restrictive changes of the lung. Subsequently, the F-v curve was observed in 40 patients with mitral stenosis (MS), aortic regurgitation (AR), congestive cardiomyopathy (CCM) and acute myocardial infarction (AMI). The V_50/V_25 ratio of these patients was significantiy higher than that of normal subjects. In parallel with the progress of heart failure indicated by NYHA's functional classification, the V_50/V_25 ratio had a higher value and the V_25 had a lower value. It was, thus, suggested that not only the restrictive change but also the obstructive change was induced by pulmonary congestion. The effect of furosemide on the F-v curve was observed in 19 patients with congestive heart failure. The improvements of the V50/V 25 ratio, percent vital capacity and Pao_2 were revealed in the patients with the higher grade of NYHA's functional classification. In conclusion, the F-v curve, especially the parameter V50/V25 ratio is of great use for assessing the restrictive change of the lung in heart disease with pulmonary congestion.
- 神戸大学の論文