右心カテーテル法による心肺機能の研究—II．心疾患と肺疾患における心肺機能の比較

Studies on Cardiopulmonary Functions.:II. A Comparison With Cardiocirculatory Disease and Pulmonary Disease.

　著者はさきに，肺機能を換気・血流分布関係から分析的に把握するところの，高低両酸素吸入により，死腔率（V_D/V_T％），酸素拡散容量（Do₂ml/min/m²/mmHg）及び静脈性混合率（Qva/Qt％）を測定するRiley等のtrial and error法^1）を中心として種々の吟味検討を加えたが^2），本稿では各種の心肺疾患々者について，本法による肺機能を主として心肺機能の病態を知るとともに，心疾患群と肺疾患群とに二大別して比較検討をこころみた。

　The disturbances of gas and blood distribution in the lungs, and of the diffusion across the res-piratory membrane, have been studied in thirty-six cases of patients with different cardiocirculatory diseases (Group C) and in thirty-four cases of patients with different pulmonary diseases (Group P) by a method employing two distinct levels of oxygenation. After that a comparison was made betwe-en these two groups with these cardiopulmonary functions.

　No significant differences could be found between Group C and P with reference to the arterial blood oxygen saturation and pressure at rest. The expired air volume was increased in both groups, but in Group P it was more increased than Group C. The arterial blood carbon dioxide tension was increased in one case in Group C and in three cases in Group P, but it was decreased in some cases of cardiac diseases. In Group C a remarkable decrease was found in the mixed venous blood oxygen saturation and cardiac index, and they became lower as the disease progressed. The diffusion abnor-malities in the lungs were found more in Group C than in Group P, but the reverse was found on the percent dead space. The percent venous admixture was similarly increased in both groups. In the later stage of these diseases, no significant differences could be found any longer between these two groups with reference to the ventilation-perfusion relationships in the lungs, except a remarkable decrease of the mixed venous blood oxygen saturation and cardiac index in Group C.

　The significance and possible causes of these findings were discussed.