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成人呼吸窮迫症候群の早期診断とサーファクタントによる不可逆期への移行阻止
https://doi.org/10.24517/00066226
https://doi.org/10.24517/00066226d9e1308f-0dd0-4222-acb7-ef65f69fc17f
名前 / ファイル | ライセンス | アクション |
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ME-PR-KOBAYASHI-T-kaken 1999-4p.pdf (198.9 kB)
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Item type | 報告書 / Research Paper(1) | |||||
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公開日 | 2022-06-03 | |||||
タイトル | ||||||
タイトル | 成人呼吸窮迫症候群の早期診断とサーファクタントによる不可逆期への移行阻止 | |||||
タイトル | ||||||
言語 | en | |||||
タイトル | ARDS : early diagnosis & prevention of irreversible change by surfactant therapy | |||||
言語 | ||||||
言語 | jpn | |||||
資源タイプ | ||||||
資源タイプ識別子 | http://purl.org/coar/resource_type/c_18ws | |||||
資源タイプ | research report | |||||
ID登録 | ||||||
ID登録 | 10.24517/00066226 | |||||
ID登録タイプ | JaLC | |||||
著者別表示 |
Kobayashi, Tsutomu
× Kobayashi, Tsutomu |
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提供者所属 | ||||||
内容記述タイプ | Other | |||||
内容記述 | 金沢大学医学部 | |||||
書誌情報 |
平成9(1997)年度 科学研究費補助金 基盤研究(B) 研究成果報告書概要 en : 1997 Fiscal Year Final Research Report Summary 巻 1995 – 1997, p. 4p., 発行日 1999-03-15 |
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抄録 | ||||||
内容記述タイプ | Abstract | |||||
内容記述 | (1)成人(急性)呼吸窮迫症候群(ARDS)の可逆期判定実験:ラットにエンドトキシン、エラスターゼ、リゾレシチン、および抗サーファクタント蛋白B抗体などを投与した実験で、動脈血酸素分圧(PaO_2)が低下し始めてから6時間以内は、サーファクタント補充療法により症状が改善する可逆期であることが判明した。しかし、PaO_2が低下し始めた時点から、肺胞には硝子膜の形成が認められたので、この時点から器質的変化を防止する措置(人口呼吸法の改善やサーファクタント補充療法など)を開始する必要があると結論された。 (2)サーファクタント投与方法の検討と人工製品の開発:ラットのARDS様の呼吸不全に対し、5時間以内に天然加工型サーファクタント(SurfactantCK)を噴霧吸入させると、症状が改善し、不可逆期への移行を6時間は遅らせることが出来た。また、合成のジパルミトイールレシチン、ホスファチジルグリセロール、ジオレイ-リルシチン(60:20:20)にサーファクタント蛋白のSP-BとSP-Cを0.7%と1.4%ずつ加えた人工製品でも、上記の効果を得ることができた。 (3)肺サーファクタントの状態と肺血管抵抗の関係:サーファクタントが不活化すると、その肺胞の毛細血管が拡張し、換気-血流比が極度に小さくなることを見い出した。この所見は、ARDSにおける低酸素血症の発生機序を明確にしたもので、呼吸管理学上、意義あるものと考えられた。 (4)ARDSの早期診断に関する検討:気管内より吸引した液体の表面活性を測定することにより、ARDSの早期診断が可能であることを予測させる所見を得た。検討を続行中である。 |
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抄録 | ||||||
内容記述タイプ | Abstract | |||||
内容記述 | (1) Determination of the reversible period in adult (acute) respiratory distress syndrome (ARDS) : In experiment to administrate endotoxin, elastase, lysolecithin, and anti-surfactant protein B monoclonal antibody in rats and rabbits, the ARDS-like symptom could be reversed by surfactant replacement until 6 hours after the arterial oxygen pressure (PaO_2) started to decrease. Therefore, 6 hours after the onset of the symptom was thought to be the reversible period. Formation of hyaline membrane, however, was noted in the alveoli even at the reversible period, uggesting that some cares should be taken to prevent the organic changes as early as possible. (2) Replacement method of surfactant and development of artificial surfactant : In rats, inhalation of an aerosolized surfactant (modified natural surfactant, Surfactant CK) reversed symptoms of ARDS-like lung injury which was induced by administration of endotoxin. By this procedure, the organic change of the lung tissue, an irreversible damage, could be postponed at least for 6 hours. In addition, an artificial surfactant which was prepared with synthetic dipalmitoyl-phosphatidylcholine, phosphatidylglycerol and dioleoylphosphatidylcholine (60 : 20 : 20) plus surfactant protein B (0.7%) and C (1.4%) exhibited the same effects with Surfactant CK. (3) Relation between condition of pulmonary surfactant and vascular resistance : We found that inactivation of pulmonary surfactant induces dilatation of the capillary vessels of the alveoli. We think that this is an important finding to explain the mechanism of hypoxemia in ARDS. (4) Early diagnosis of ARDS : We have obtained some findings that surface tension values of the liquid aspirated from the trachea may by useful for early diagnosis of ARDS. |
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内容記述 | ||||||
内容記述タイプ | Other | |||||
内容記述 | 研究課題/領域番号:07457353, 研究期間(年度):1995 – 1997 | |||||
内容記述 | ||||||
内容記述タイプ | Other | |||||
内容記述 | 出典:研究課題「成人呼吸窮迫症候群の早期診断とサーファクタントによる不可逆期への移行阻止」課題番号07457353 (KAKEN:科学研究費助成事業データベース(国立情報学研究所)) (https://kaken.nii.ac.jp/ja/report/KAKENHI-PROJECT-07457353/074573531997kenkyu_seika_hokoku_gaiyo/)を加工して作成 |
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著者版フラグ | ||||||
出版タイプ | AM | |||||
出版タイプResource | http://purl.org/coar/version/c_ab4af688f83e57aa | |||||
関連URI | ||||||
識別子タイプ | URI | |||||
関連識別子 | https://kaken.nii.ac.jp/search/?qm=40019922 | |||||
関連名称 | https://kaken.nii.ac.jp/search/?qm=40019922 | |||||
関連URI | ||||||
識別子タイプ | URI | |||||
関連識別子 | https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-07457353/ | |||||
関連名称 | https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-07457353/ | |||||
関連URI | ||||||
識別子タイプ | URI | |||||
関連識別子 | https://kaken.nii.ac.jp/ja/report/KAKENHI-PROJECT-07457353/074573531997kenkyu_seika_hokoku_gaiyo/ | |||||
関連名称 | https://kaken.nii.ac.jp/ja/report/KAKENHI-PROJECT-07457353/074573531997kenkyu_seika_hokoku_gaiyo/ |