Pathophysiology of emphysema.
Pathophysiology of emphysema.
复制标题
肺气肿的病理生理学。
DOI：
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发表时间：
1983
期刊：
影响因子：
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通讯作者：
Robinson Ag
中科院分区：
文献类型：
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作者：
Robinson Ag
：肺气肿的病理生理学最好是根据肺弹性回缩力降低来解释。在任何胸膜压下，肺容量都高于正常值。此外，胸膜压和肺泡压之间关系的改变有利于气道的呼气动态压缩。这种压缩限制了用力呼气期间的气流，并且在严重的情况下，限制了潮气呼气期间的气流。导致气流受限的另一个因素是呼吸道疾病，无论大小。一般来说，患有相对单纯性肺气肿的患者直到病程晚期都将血气维持在或接近正常范围。由于肺泡壁被破坏时通气和灌注的匹配得以保留，因此 PaO2 得以维持。 PaCO2 得以维持，因为对 CO2 的通气反应通常不会受损。目前尚不清楚为什么临床上被归类为“慢性支气管炎”的患者更有可能因通气不足而对呼吸阻力增加做出反应。肺气肿的体格检查结果并不具体。放射学变化不敏感，并且其价值低于生理测量。
: The pathophysiology of emphysema is best explained on the basis of decreased pulmonary elastic recoil. At any pleural pressure, the lung volume is higher than normal. Additionally, the altered relation between pleural and alveolar pressure facilitates expiratory dynamic compression of airways. Such compression limits airflow during forced expiration and, in severe instances, during tidal expiration. Another factor contributing to airflow limitation is disease of the airways, both large and small. In general, patients with relatively pure emphysema maintain blood gases in or near the normal range until very late in their course. PaO2 is maintained because of the preserved matching of ventilation and perfusion as alveolar walls are destroyed. PaCO2 is maintained because the ventilatory response to CO2 is not usually impaired. It is not clear why patients who are categorized clinically as "chronic bronchitics" are more likely to respond to an increased flow-resistive work of breathing by hypoventilating. Physical findings in emphysema are not specific. Radiologic changes are insensitive and are of less value than physiologic measurements.