Clinical effects of long-term spa therapy on pulmonaryemphysema. Evaluation by pulmonary function and pathological changes of terminal airspace of the lung

Abstract

Clinical effects of long-term spa therapy for 4 years were estimated in 8 patients of pulmonary emphysema (4 with spa therapy and 4 without spa therapy) by pulmonary function and morphological changes of peripheral airspaces of the lung on high - resolution computed tomography (HRCT). 1 . The values of % FVC, % FEV1.0, and FEV 1.0% did not significantly change for 4year observation both in patients with spa therapy and those without spa therapy. 2. The OLco value significantly decreased from 69.9% at the initial level to 48.8% after 4-year observation in patients without spa therapy (p<O.02). However, the DLco value did not significantly decrease in patients with spa therapy. 3. The values of % RV and % LAA of the lung showed a significant increase in patients without spa therapy (% RV: p<O.05, % LAA: p<O.Ol after 4-year observation compared with the initial levels), however, a change in % RV and % LAA was not significant in patients with spa therapy. 4. The CT number also significantly decreased in patients without spa therapy, but not in those with spa therapy. The results suggest that spa therapy improves % DLco, % RV and morphological changes of peripheral airspaces, chiefly overinflation, of the lung in patients with pulmonary emphysema.肺気腫に対する4年以上にわたる温泉療法の臨床効果を,肺機能の面および末梢肺領域の形態学的変化により評価した｡ 1.FVC,% FEV1.0,およびFEV1.0%値は,温泉療法を受けた症例と受けなかった症例の間に有意の差は見られなかった｡ 2.拡散能(DLco)は,温泉療法を受けなかった症例では,観察初期の69.9%から4年後には48.8%と有意の低下を示したが,温泉療法を続 けた症例では,有意の低下は見られなかった｡ 3.% RVおよびHRCT上の-950HU以下の肺のlow attenuation area(LAA)は,いずれも温泉療法を受けなかった症例では有意の増加傾向を示したが,温泉療法を受けた症例では有意の増加傾向は見られなかった｡ 4.Crnumberは,温泉療法を受けなかった症例では有意の低下を示したが,温泉療法を続けた症例では有意の変化は見られなかった｡これらの結果より,肺気腫に対する温泉療法を続けることにより,% DLcoや % RVは改善する傾向を示し,同時に肺胞の過膨脹の部分(破壊された部分ではなく)が改善されていく可能性が示唆される