| Co-Investigator(Kenkyū-buntansha) |
FUJIMOTO Keisaku Shinshu University, School of Medicine, Senior Assistant Professor (70242691)
OTA Masao Shinshu University, School of Medicine, Senior Assistant Professor (50115333)
HANAOKA Masayuki Shinshu University, School of Medicine, Senior Assistant Professor (20334899)
URUSHIHATA Kazuhisa Shinshu University, Hospital, Assistant Professor (60362125)
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| Budget Amount *help |
¥3,820,000 (Direct Cost: ¥3,400,000、Indirect Cost: ¥420,000)
Fiscal Year 2007: ¥1,820,000 (Direct Cost: ¥1,400,000、Indirect Cost: ¥420,000)
Fiscal Year 2006: ¥2,000,000 (Direct Cost: ¥2,000,000)
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| Research Abstract |
1) The epidemiological investigation of early-onset COPD in Japan.
The analysis of the detailed data obtained from 90 patients with early-onset chronic obstructive pulmonary diesease (COPD) showed that the ratio of male to female was 77/13, indicating more prevalence of the disorder in male than male with correspondence to the high rate of smoking in male. This result suggested that, in addition to al-AT, the patients susceptible to early-onset COPD were sensitive to smoking, probably in linkage to smoking history in which the patients exposed to smoking at early age of teenage. The investigation showed that 16.7% of the patients were in pulmonary cachexia status with body mass index (BMI) under 18 and that most of them were severe cases. Thus, it seems that the dystrophia is probably one of the reasons in severe earns with early onset COPD and, therefore, nutrition therapy should be provided in early stage. Moreover, the patients with history of hospitalization presented low BMI, long
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history of passive smoking, more frequency in complication with asthma or having a history of asthma, and severe airflow limitation, pulmonary hyperinflation and dyspnea (by MRC scale). The chest CT illustrated that although 15.2% of the cases did not show emphysematous change, the prevalence of patients with LAA% < 25% was 23%. Regarding the emphysema phenotype, 77% of the patients showed centrlobular emphysematous type, in consistent with the distribution in common COPD. Additionally, similar to previous clinical report concerning early onset COPD, most of the cases without typical emphysematous change were females. Moreover it was relatively high proportion of patients who were difficultly differentiated from asthma Or sinobronchial syndrome if such complications were occurred in early-onset COPD.
2) Clinical features of patients with combined pulmonary fibrosis and emphysema.
Smoking appears to be the predominant risk factor for not only pulmonary emphysema but also pulmonary fibrosis. Patients with combined pulmonary fibrosis and emphysema are reported occasionally. By computed tomography, we screened 25 patients with combined pulmonary fibrosis and emphysema and 90 patients with stable COPD showing only emphysematous change without fibrosis and then analyzed clinical features of the patients with combined pulmonary fibrosis and emphysema. We found that all the patients with combined pulmonary fibrosis and emphysema were males. The paraseptal emphysematous type was significantly more frequent in such patients. Lung cancer was observed in more than half of the patients. All the patients showed that pulmonary fibrosis was distributed in the lower lobe of the lung. Regarding the lung function, the patients had mild hyperinflations and significantly reduction in lung diffusing capacity. Taking together, the clinical features of patients with combined pulmonary fibrosis and emphysema distinctly differ from those with pulmonary emphysematous change only. Particular attention should be paid to the frequently occurred lungcancer in such patients. Less
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