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Kokyu to Junkan Volume 31, Issue 12 （December 1983）

呼吸と循環 31巻12号（1983年12月発行）

Japanese English

研究

高度肺高血圧を呈する僧帽弁狭窄症の肺内血流分布および換気分布様式の特徴 The distribution of pulmonary perfusion and ventilation in mitral stenosis with extreme pulmonary hypertension 倉田直彦 ¹ , 竹内義広 ¹ , 大井勉 ¹ , 森本保 ¹ , 金田正徳 ¹ , 三宅信也 ¹ , 北村文夫 ¹ , 並河尚二 ¹ , 湯浅浩 ¹ , 草川實 ¹ Naohiko Kurata ¹ , Yoshihiro Takeuchi ¹ , Tsutomu Ooi ¹ , Tamotsu Morimoto ¹ , Masanori Kaneda ¹ , Shinya Miyake ¹ , Humio Kitamura ¹ , Shoji Namikawa ¹ , Hiroshi Yuasa ¹ , Minoru Kusagawa ¹ ¹三重大学胸部外科 ¹The Department of Thoracic Surgery, Mie University School of Medicine pp.1339-1345

発行日 1983年12月15日 Published Date 1983/12/15

DOI https://doi.org/10.11477/mf.1404204361

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Abstract 文献概要
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　僧帽弁狭窄症に合併する肺高血圧の術後寛解の程度は，術後急性期および遠隔期における手術成績を左右する大きな因子であると考えられる。そこで，我々は，高度肺高血圧を呈する僧帽弁狭窄症症例に，¹³³Xeを用いた局所肺機能検査を施行し，単位肺容量当りの血流分布および換気分布様式を術後遠隔期まで観察し，肺高血圧の術後改善の程度を術前に予測しうる可能性を検討した結果，従来の報告にみられない有用な知見を得たので報告する。

The purpose of this study is to investigate the changes of regional distribution of pulmonary perfusion and ventilation in mitral stenosis with extreme pulmonary hypertension (mPAP<4040 mmHg) following surgical treatment. For the assessment of the regional perfusion and ventilation using Xe-133, perfusion index and ventilation index which mean the perfusion and ventilation per unit lung volume, have been calculated using scintilation camera-on line computer system.

The results are summarized as follows.

1. Ten patients have been studied.2. There were two types of distribution of pulmonary perfusion. Type A showed the inverted distribution of normal distribution of pulmonary perfusion, as well known according to the many past reports. Type B showed the distribution uniform throughout the lung. 3. The patients with type B had severe pulmonary vascular resistance and abnormal distribution of ventilation. 4. Postoperatively, the distribution of pulmonary perfusion in type A returned to normal after 6-12 months of surgical treatment, but in the type B never returned to normal even after 12 months of surgical treatment. 5. In hemodynamic datas after 3-6 months of surgical treatment, the patients with type B showed the moderate pulmonary hypertension and pulmonary vascular resistance. 6. The abnormal distribution of ventilation in patients with type B improved in normal distri- bution after 12 months of surgical treatment. 7. In conclusion, perfusion index and ventilation index are very beneficial to estimate the pulmo- nary hypertension in mitral stenosis with or without high pulmonary vascular resistance before surgical treatment, and these two indices are good markers to estimate the improvement of regional pulmonary perfusion and ventilation along with the improvement of hemodynamic datas after surgical treatment.