びまん性汎細気管支炎，慢性肺気腫の気道抵抗およびその不均等換気の特異性について

Characteristics in airway resistance and uneven ventilation in patients with diffuse panbronchiolitis (DPB) and diffuse pulmonary emphysema

　びまん性汎細気管支炎（以下DPB）は本間，山中らによる疾患概念の提唱以来，広く注目を集めつつある疾患である。

　厚生省特定疾患間質性肺疾患調査研究班による3年にわたるDPB全国症例の調査，研究により^1），その臨床像の全体が明らかにされつつある。しかし，その診断は生検例を別にすれば，主に息切れと喀痰，胸部レ線所見を中心に，換気機能障害を参考にして行われているのが現状である。

Diffuse panbronchiolitis (DPB) is a unique disease having characteristics of obstructive and restrictive dysfunction with marked abnormality of gas exchange. Flow vs pressure diagram obtained by bodyplethysmographic technic under BTPS condition using Jaeger OM04 could express char-acteristics of pulmonary dysfunction of DPB.

Flow vs pressure diagram in patients with DPB exhibited loop formation both in inspiratory andexpiratory phase, but only in expiratory phase in patients with diffuse pulmonary emphysema.

Generally, it is accepted that loop formation in flow vs pressure diagram express uneven ventila-tion, if it is obtained under BTPS condition. It was thought that loop formation was attributable to its specific lesion in broncho-bronchiolar wall in pa-tients with DPB, but to expiratory dynamic com-pression due to loss of lung elasticity in patients with emphysema.