肺結核症の肺機能に関する研究--特にFlow-Volume曲線およびClosing Volumeと諸因子との関連性
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It has not been studied enough on pulmonary function impairment of patients with pulmonary tuberculosis by using Flow-Volume Curve and Closing Volume. We examined various factors of pulmonary tuberculosis, Flow-Volume Curve, N<SUB>2</SUB>-Closing Volume, fraction of lung volume, FEV<SUB>1.0</SUB>/VC% and VC, % in 420 cases who were being hospitalized as pulmonary tuberculosis or its sequelae at Tokyo National Chest Hospital and The First Department of Internal Medicine, Nihon University School of Medicine. The results obtained were as follows:<BR>1) With the increase in the extent of pulmonary tuberculosis, a decrease of V max is observed, and an increase of each ΔN<SUB>2</SUB>/L phase III, CV/VC%, CC/TLC%, CC/FRC% become stronger and the variability of the index of V max except V max 10 also increases, but the variability of CV, ΔN<SUB>2</SUB>/L phase III shows no relation with the extent of pulmonary tuberculosis. Its variability is smaller compared with that of V max.<BR>2) Confining cases to Moderately Advanced Ones (N. T. A.), the regression equation curve of FEV<SUB>1.0</SUB>/VC% and that of V. max are steeper in higher age groups, and positive significant correlation is found between them. The F-V Curve-Area of the aged is approximately one-thirds of the young patients.<BR>3) Though the regression equation curve of CV/VC% in patients with lesions in unilateral upper lung zone approaches by aging to the equation curve of "Buist and Ross" which is considered to be the standard of the normal persons, it dissociates in cases with lesions in the bilateral upper lung zone. Regarding ΔN<SUB>2</SUB>/L phase III, it dissociates by aging from the standard equation of the "Buist and Ross" in both cases.<BR>4) There are certain number of cases with no clear CV (phase IV) among cases which have conspicuous lesions on X-Ray in the whole bilateral upper lung zone.<BR>5) In cases of pleural lesion, CV/VC% shows a slight increase, and ΔN<SUB>2</SUB>/L phase III remarkable one, while V max shows a marked decrease.<BR>6) Confining cases to Moderately Advanced Ones, the influence of pleural lesion appears in V max. On the other hand, in Far Advanced Cases, the influence of emphysematous change does not appear in V max. In these cases, the usefulness of F-V Curve is quite small.<BR>7) In the cases of complicated lesions with deformity due to surgical treatment, a decrease of V max and increases of CV and ΔN<SUB>2</SUB>/L phase III are remarkable. No significant correlation is found among V max, CV and ΔN<SUB>2</SUB>/L phase III.<BR>8) In most of the cases with pulmonary tuberculosis which shows the decrease of VC% and that of FEV<SUB>1.0</SUB>/VC%, a decrease of V max and an increase of ΔN<SUB>2</SUB>/L phase III, CV are observed.<BR>Although there are many difficulties in evaluating F-V Curve and CV in pulmonary tuberculosis, we are able to point out that these new pulmonary function tests have some usefulness over the traditional one in managing pulmonary tuberculosis.
- 一般社団法人 日本結核病学会の論文