Multidisciplinary study on the organ interrelation between swallowing and regulation of respiration for furthering the quqlity of life in the elderly

吞咽与呼吸调节之间的器官相互关系的多学科研究以提高老年人的生活质量

• 批准号: 07407016
• 负责人: FUKUCHI Yoshinosuke
• 金额: $ 16.13万
• 依托单位: Juntendo University School of Medicine (1996-1997)The University of Tokyo (1995)
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (A)
• 财政年份: 1995
• 资助国家: 日本
• 起止时间: 1995 至 1997
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-07407016/
• 关键词: SWALLOWING; ASPIRATION PULMONARY DISORDERS; SWALLOWIN PROVOCATION TESTS; MANOFLUOROGRAPHY; DEGLUTITION CENTER; ASPIRATION PNEUMONIA; DIFFUSE ASPIRATION BRONCHIOLITIS; SYSTEMIC SCLEROSIS; 燕下機能; PETスキャン; 燕下中枢; ビデオフルオログラフィ; 燕下誘発テスト; 燕下性肺炎; 嚥下誘発

The results of multidisciplinary study on the relationship between swallowing and regulation of respiration for three years are summarized as follows ; 1) Aspiration pulmonary diseases (APD) were found in more than 2 % of all elderly inpatients in general hospitals. 2) Cerebrovascular diseases, dementia and malignancies are common background diseases, and impairment of active daily life is the most important risk factor of APD.3) The new techniques such as swallowing provocation test (SPT) and manofluorgrapy (MF) are quantitative and reproducible tests for assessment of swallowing function, and are useful for early detection of high-risk patients with APD.They are also helpful for the assessment of therapeutic effectiveness of APD.4) Swallowing appears to be regulated by multiple cerebral regions including bilateral operculum, insula and basal ganglia, and these regions may cooperate in conjunction with brain stem central program generation of deglutition. 5) SPT is helpful to assess t … More he function of second phase of swallowing, and correlates with the bolus passage time in MF.6) SPT and MF are so sensitive for evaluation of swallowing that impaiment by aging is frequently found even in the healthy elderly. 7) The effectiveness of optimal regulation of dietary contents and frequency is verified by evaluating the patients with dysphasia using MF.8) Prospective study revealed that the patients with abnormal SPT findings are predicted to haveaa higher martality rate of aspiration pneumonia. 9) Clinical entity of APD was established and nation-wide surveillance for diffuse aspiration bronchiolitis (DAB) was carried out. The study revealed DAB is found through out the country, and occurs even in younger patients. 10) It is verified that APD is one of important prognostic factors in patients with systemic sclerosis (SSc). 11) Esophagus scores, a new indicator of aspiration in SSc, may be useful for early detection and propylaxic prevention of APD.12) Percutaneous endoscopic gastrostomy (PEG) is confirmed as an effective therapeutic intervention regarding nutritional maintenance and prevention of APD.These observations revealed close organ interrelation between swallowing and respiratory system and confirmed the significance of its understanding to promote quality of life in the elderly. Less

本文总结了三年来有关吞咽与呼吸调节关系的多学科研究结果：1）吸入性肺病（APD）在综合医院所有老年住院患者中占2%以上。2)脑血管病、痴呆和恶性肿瘤是常见的背景疾病，日常生活活动障碍是APD最重要的危险因素。3）吞咽激发试验（SPT）和荧光造影（MF）等新技术是评价吞咽功能的定量和可重复的试验，有助于APD高危患者的早期发现，也有助于APD治疗效果的评估。吞咽似乎是由多个大脑区域，包括双侧盖，小脑和基底神经节，这些区域可能合作与脑干中央程序的吞咽的产生。5)标准贯入试验有助于评估 ...更多信息 6）SPT和MF对吞咽功能的评价非常敏感，即使在健康的老年人中也经常发现年龄的影响。7)通过对言语障碍患者进行MF评估，验证了饮食内容和频率的最佳调节的有效性。8）前瞻性研究显示，SPT异常的患者预计有较高的吸入性肺炎死亡率。9)建立了APD临床实体，并在全国范围内开展了弥漫性吸入性细支气管炎（DAB）监测。这项研究显示，DAB在全国各地都有发现，甚至在年轻患者中也有发生。10)APD是影响系统性硬化症（SSc）患者预后的重要因素之一。11)食管评分是SSc误吸的新指标，可能有助于APD的早期检测和丙戊酸钠预防。12）经皮内窥镜胃造口术（PEG）证实是一种有效的营养维持和预防APD的治疗干预。这些观察揭示了吞咽和呼吸系统之间密切的器官相关性，并证实了理解吞咽对提高生活质量的重要性。老人少

项目成果

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Yasuhiro Yamaguchi. Yoshinosuke Fukuchi：“使用视频荧光检查 (VF) 和吞咽激发试验 (SPT) 评估瓦伦堡综合征的病例”，《日本医学杂志》34. 331-336 (1997)。

S.Teramoto, Y.Uejima, T.Oka, K.Teramoto, T.Matsuse, Y.Ouchi, and Y.Fukuchi: "Effects of chronic cigarette smoke inhalation on the development of senile lung in senescence-accelerated mouse." Research in Experimental Medicine.197. 1-11 (1997)

S.Teramoto、Y.Uejima、T.Oka、K.Teramoto、T.Matsuse、Y.Ouchi 和 Y.Fukuchi：“长期吸入香烟烟雾对加速衰老小鼠的老年肺发育的影响”。

S.Teramoto, Y.Fukuchi, T.Nagase, T.Matsuse and H.Orimo.: "A comparison of ventilation components between elderly and young men during exercise." J.Gerontol.(Biol.Sci.). 50. B34-B39 (1995)

S.Teramoto、Y.Fukuchi、T.Nagase、T.Matsuse 和 H.Orimo.：“老年人和年轻人运动期间通气部件的比较。”