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Kokyu to Junkan Volume 37, Issue 11 （November 1989）

呼吸と循環 37巻11号（1989年11月発行）

Japanese English

研究

パパイン処理前後におけるイヌ肺機能検査成績の変化と病理所見 Correlation between the function and structure in papain-induced emphysema in dogs 白石晃一郎 ¹ , 福田陽一 ¹ , 中川潤 ¹ , 本宮雅吉 ¹ Koichiro Shiraishi ¹ , Yoichi Fukuda ¹ , Jun Nakagawa ¹ , Masakichi Motomiya ¹ ¹東北大学抗酸菌病研究所内科 ¹The Research Institute for Tuberculosis and Cancer, Tohoku University pp.1203-1208

発行日 1989年11月15日 Published Date 1989/11/15

DOI https://doi.org/10.11477/mf.1404205578

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Abstract 文献概要
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　蛋白分解酵素であるパパイン，あるいはエラスターゼを用いて，実験的に確実に肺気腫を作製し得ることは，同時に発見されたアンチトリプシン欠損症とあわせて，肺気腫の成因に，蛋白分解酵素が関係していることを示すものとして注目された。

　パパインのエロゾールの吸入，または溶液の注入によって作製される肺気腫が，1）どのような肺機能検査成績を示すか，2）作製された肺気腫の病理形態学的計測値と，どの肺機能検査測定値が，良い対応を示すか，3）逆にin vivoの肺機能検査測定値から，肺の気腫性変化の程度を推定するのに，有用な指標は何かを検討するために，以下のような実験を行った。このような関係を求めておくことは，どの程度の肺気腫が存在するかを，生存時に知る手がかりとなると考えた。

To examine the relationship between morphologic changes and the alteration of pulmonary function, papain solution was administered to 11 dogs by inhalation and to 5 dogs by a single intratracheal injection.

Pulmonary function tests, including determination of lung volume subdivision, diffusing capacity (DL_co), pressure-volume relationship of the lung and arte-rial blood gas were performed before and after papain treatment.

The dogs were then killed and the lungs proces-sed for patholigic studies. The severity of emphy-sema was graded as percent of emphysema according to Dunill's method and we compared this to the antemortem pulmonary function data. Exponential constant K was determined by fitting lung pressure-volume data to the equation V= V₀(1-e^-KP).

After papain administration, DLco decreased, K of the pressure-volume curve increased, and arterial blood oxygen pressure reduced significantly. The changes of residual volume, the ratio of residual volume to total lung capacity, DLco per unit lung volume, and the values of the exponential functions of pressure-volume data were correlated with the severity of emphysema with statistical significance, but none of them showed excellent order correlation.

Multiple regression equation using 2 to 4 of the parameters indicated that the severity of emphysema can be predicted more accurately.

We conclude that recognition of the severity of emphysema requires a multivariate approach includ-ing the determination of lung volume, DLco, and pressure volume relationship of the lung, because the relationship between the severity of emphysema and the values obtained with these measurements are nonlinear.