慢性気管支炎患者の換気機能について—就中閉塞性換気障害の意義

Studies on Ventilatory Function in Chronic Bronchitics:Special review of obstructive ventiratory impairment.

I．緒言

　慢性気管支炎に対し，わが国の胸部臨床家達が関心を示しはじめたのは最近の事である。その主な契機は以下の如きものであろう。

　1）大戦中一時とだえたいた欧米医学との交流が復活し，その結果，本疾患に対する従来の見解を大巾に変革すべき必要性を感じはじめたこと。

　2）肺結核症に対する関心が漸く一時期を画したこと。

　3）近代産業の発展に伴う生活環境の汚染

　4）近代の肺機能研究の進展言及により，胸部疾患に対し新たな病態生理学的探究が開始されたこと，などである。

　とりわけ4）の契機の関与する所大であり，慢性閉塞性肺気腫，しいてはその発生に対する重要な因子と目される慢性気管支炎に対する多くの興味を生じるにいたつた。

On the results of spirographic analyses in 54 bronchitics whose diagnostic criteria were based on Fletcher's definition, the patients were classified into four types as follows:25 cases have normal ventilatory functions, 2 have restrictive impairment, 19 have obstruc-tive impairment (included 1 case with chronic obstructive pulmonary emphysema), and 8 have combined impairment (included 6 with chronic obstructive pulmonary emphysema).

The ventilatory functions in chronic bronchitics showed polymorphic appearances on process of establishment of complete emphysematous manifestations. Obstructive types were considered as a intermediary position between the early stage (without ventilatory impair-ment) and the lastest stage (with established emphysematous manifestations).

The reversibilities of an airway obstruction by inhaled isuprel in chronic bronchitics were worse as typical bronchial asthmatics.

On increased resudual volume/total lung capacity ratio and a high values of intrapulmo-nary mixing index were notable somethinies in early stage.