Studies on Prognosis of Chronic Pulmonary Emphysema with Special Reference to Abnormalities in Pulmonary Circulation and Arterial Blood Gases

摘要

Thirty-six patients with chronic pulmonary emphysema have been investigated by pulmonary function tests, and followed up for 5 to 8 years, and the results were as follows.(1) Seven cases died within 2 years and 9 within 3 to 5 years, 7 died from cor pulmonale.(2) In the patients with vital capacity of less than 65 per cent of predicted or with maximal breathing capacity of less than 40 per cent of predicted, the largest number of deaths occurred within 5 years, but considerable number of survivals were also noticed. The relationship of the residual volume as a percentage of the total lung capacity to prognosis was not evident.(3) All the patients with the arterial oxygen saturation of lower than 87 per cent or with the arterial carbon dioxide tension of higher than 55mm.Hg died within 5 years, although considerable number of deaths occurred not only in patients with subnormal values but also in those with normal values of both tests. But the survivals over 5 years were noticed only in patients with the arterial oxygen saturation above 87 per cent or carbon dioxide tension below 55mm. Hg.(4) All the patients with mean pulmonary arterial pressure of higher than 30mm.Hg or total pulmonary resistance of higher than 500 dynes sec. cm.-5 died within 5 years. On the other hand, the survivals over 5 years appeared in patients with the former lower than 30mm.Hg or the latter lower than 500 dynes sec. cm.-5 The relationship of the pulmonary blood flow to prognosis was not evident.(5) The prognostic significance of the pulmonary function tests has been discussed and it was suggested that the arterial carbon dioxide tension in combination with the maximal breathing capacity was a useful guide to the prognosis.