Spirometric and radiological evaluation of the remnant lung long after major pulmonary resection: can compensatory phenomena be recognized in clinical cases?

大肺切除术后残肺的肺量测定和放射学评估：在临床病例中能否识别代偿现象？

• 批准号: 23592054
• 负责人: MIZOBUCHI TERUAKI
• 金额: $ 3.33万
• 依托单位: Chiba University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 2011
• 资助国家: 日本
• 起止时间: 2011 至 2013
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-23592054/
• 关键词: 呼吸器外科学; 代償性肺成長; 肺再生; 肺切除; 仮想肺組織量; 再生医療; II型肺胞上皮; 肺癌; 生体肺移植; 体性幹細胞; 手術; COPD

It has been generally accepted that lungs cannot regenerate in mature human. After a major lung resection, however, mechanical stretch, shear stress, and a variety of growth factors are induced in the remnant lung, and those are known to be driving forces for compensatory lung growth in animal models. Radiologically estimated "Lung Weight" is focused on as a significant parameter to determine severity of ARDS that is calculated by lung volume and density. Therefore, we also utilized the concept of radiologic estimation of lung weight for evaluation of the compensation. Before clinical investigation, a rational of radiologic lung weight was validated in healthy volunteers. This result met our hypothesis that radiologic lung weight is constant at any respiratory phase. Hypertrophic change of the remnant lung was recognized in living lung donors and lung cancer patients who underwent more than a 10-subsegment resection.

人们普遍认为，成年人的肺是不能再生的。然而，在大肺切除后，残余肺会受到机械拉伸、剪切应力和多种生长因子的诱导，而这些已知是动物模型中代偿性肺生长的驱动力。放射学估计的“肺重”是确定ARDS严重程度的重要参数，由肺体积和密度计算。因此，我们也利用肺重量的放射学估计的概念来评估代偿。在临床研究之前，在健康志愿者中验证了放射学肺重量的合理性。这一结果符合我们的假设，即放射学肺重量在任何呼吸期都是恒定的。残肺的肥厚变化在活肺供者和接受超过10亚段切除的肺癌患者中被识别出来。