SITE AND NATURE OF AIRWAY OBSTRUCTION IN CHRONIC OBSTRUCTIVE LUNG DISEASE
SITE AND NATURE OF AIRWAY OBSTRUCTION IN CHRONIC OBSTRUCTIVE LUNG DISEASE
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DOI：
10.1056/nejm196806202782501
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发表时间：
1968-01-01
影响因子：
158.5
通讯作者：
THURLBECK, WM
中科院分区：
文献类型：
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作者：
HOGG, JC;MACKLEM, PT;THURLBECK, WM
在切除的人肺的气道（直径2 ~ 3mm）内插入一个小导管，测量中心（Rc）和外周（Rp）对该部位的气道阻力，5个正常肺，Rp仅占总气道阻力（Rl）的25%，平均0.18 cm水/升/秒。7例肺气肿患者Rp增高4 ~ 40倍。1例支气管扩张和1例细支气管炎的Rp也升高。总的来说，Rc分散在正常值周围。支气管造影和组织学研究显示，由于粘液堵塞、狭窄和小气道闭塞，Rp升高。小气道疾病可能是各种慢性阻塞性肺疾病的常见症状。由于Rp通常很小，周围气道可能存在相当大的阻塞，这将影响通风分布和气体交换，但对旨在显示阻塞的功能测试影响不大。当气道总阻力因小气道疾病升高到临床可检测的水平时，阻塞比一般认为的要严重得多。
A small cath-eter was wedged in the airways (2 to 3 mm in diameter) of excised human lungs to measure airway resistance central (Rc) and peripheral (Rp) to this site, m 5 normal lungs, Rp accounted for only 25% total''airway resistance (Rl) and averaged 0.18 cm of water/ liter/sec. In 7 patients with emphysema, Rp was increased from 4-40 times. Rp was also increased in 1 case of bronchiectasis and another of bronchiolitis. In all, Rc scattered around the normal value. Bronchographic and histologic studies showed that Rp was increased because of mucus plugging, narrowing, and obliteration of the small airways. Disease of small airways may be common to various chronic obstructive lung diseases. Because Rp is normally so small, there may be considerable obstruction in peripheral airways that would affect ventilation distribution and gas exchange but would have little effect on function tests designed to reveal obstruction. When total airway resistance is elevated to a clinically detectable level by disease in the small airways, obstruction is much more severe than is generally recognized.