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気管支喘息の臨床分類とその細胞性および液性因子の特徴

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  • Characteristics of humoral and cellular factors participating in onset mechanism of asthma in relation to clinical types classified by symptoms.

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Abstract

Characteristics of each asthma type classified by clinical symptoms and findings were studied in 72 patients with bronchial asthma. 1. Ventilatory function tests showed that the values of % MMF, % V(50) and % V(25) were significantly lower in patients with bronchiolar obstruction (type II) compared to the values of those with simple bronchoconstriction type (type Ia) and those with bronchoconstriction + hypersecretion (type Ib). 2. The proportion of neutrophils in bronchoalveolar lavage (BAL) fluid was significantly higher in type II than in type Ia and type Ib. Several patients with type Ib showed higher proportion of BAL eosinophils. 3. The release of LTC(4) from leucocytes was significantly lower in type II compared with type Ia and type Ib. There was no significant difference in the release of histamine and LTB(4) among the three asthma types.

気管支喘息72例を対象に,その臨床病態の特徴を,気道炎症性の細胞および化学伝達物質の観察により検討した。1.気道反応の特徴を換気機能の面から検討すると,II細気管支閉塞型において,MMF,V(50)やV(25)などの小ないし細気管支領域の換気障害を示すパラメーターの値は,Ia型,Ib型に比べ 有意の低下を示した。2.気道細胞反応では,II型において,他の臨床病型に比べ,BAL液中好中球の出現頻度の有意の増加が観察された(Ia, p<0.001 ; Ib, p<0.01)。好酸球の出現頻度は,Ib過分泌型において著しい増加傾向を示す症例が見られたが,その平均出現頻度には3病型間に有意の差は見られなかった。3.好中球からのメジェー夕ー遊離では,ヒスタミン遊離は,Ia単純性気管支撃縮型において最も高い値が示されたが,推計学的には3病型間に有意の差は見られなかった。ロイコトリエンC(4)では,Ia型においてII型に比べ有意に高い遊離が観察された(p<0.05)。ロイコトリエンB(4)遊離には,3病型間に差は見られなかった。

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