<原著>健康者及び各種呼吸器疾患患者における, 血清 α_1 アンチトリプシン (α_1AT) に関する研究

Abstract

A)健康者719例(18才&acd;90才, 男性458例, 女性261例)について血清α_1AT濃度の測定と, 表現型の検査を行ない, 性, 年令, 喫煙の影響について調査した結果下記の成績を得た。1)血清α_1AT濃度の平均値±SDは245±62mg/dl 2)男女差は認めない。3)年令の影響は, (1)25才以下, (2)26才&acd;60才, (3)61才以上に分けると, (1)<(2)<(3)となり, 加令とともに上昇する。4)喫煙者は非喫煙者より有意に高値である。5) 719例が総てMM型。B)呼吸器疾患患者群212例(肺癌50例, 肺結核63例, COPD 99例)について, 血清α_1AT濃度と表現型の検査を行なった結果下記の成績を得た。1)肺癌の平均値±SDは301±61mg/dl肺結核の平均値±SDは284&acd;±64mg/dl健康者と比べ有意に高値。(p<0.01) 2) 慢性気管支炎(12例)の平均値±SDは, 325±101mg/dl肺気腫(22例)は, 158±52mg/dl喘息成人(29例)は, 275±94mg/dl喘息小児(36例)は, 245±50mg/dl慢性気管支炎では, 健康者に比し, 有意に高値。(p<0.001) 3) 表現型は, 210例がMM型であり, 1例MS型(喘息)1例FM型(肺癌)であった。以上の成績より日本人の有するPi表現型はその殆んどがPiMであり, 少数例にPiS, PiFの存在を認めたが, 我々の調査対象中にはPiZを全く発見することができなかったことより, 我が国におけるCOPDの発病原因はPi systemの異常とは無関係であると思われた。

Serum α_1 AT concentration was measured by immuno-diffusion plate and Pi phenotypes were determined by isoelectric focusing about 719 healthy cases and 212 cases suffering from respiratory diseases. The results were summarized as follows; A) Healthy cases (Age : 18-90 years old, Sex, male 458 cases, female 261 cases) 1) Mean value of α_1AT concentration was 245±62mg/dl (mean±SD) 2) Significant difference in the mean value of α_1AT concentration was not observed between male and female. 3) Healthy group was devided into three groups by their ages. 1) under 26 years old 2) 26-60 year old 3) over 60 years old. The mean values of serum α_1AT in each group wire 236±51mg/dl, 248±69mg/dl and 282±58mg/dl respectively. The value of older group was higher than that of younger group (3>2>1) 4) Mean value of α_1AT concentration in smokers was significantly higher than that of nonsmokers. 5) Pi phenotypes of all cases were MM. B) Patients This group contained 50 cases of lung cancer, 63 cases of pulmonary tuberculosis and 99 cases of chronic obstructive pulmonary diseases (COPD) (Age : 10 82 years old, Sex : male 150 cases, female 62 cases). 1) Mean values of α_1AT concentrations were 301±61mg/dl in lung cancer, 284±64mg/dl in pul. tuberculosis respectively. Those values were significantly higher than that of healthy. Those values were significantly higher than of healhty group. 2) Mean value of α_1AT concentration in COPD group was 325±101mg/dl. Mean values of subgroups in COPD were as follows : ; Chronic bronchitis (12 cases) 325±101mg/dl Pulmonary emphysema (22 cases) 258±52mg/dl Bronchial asthma (adult, 29 cases) 275±94mg/dl Bronchial asthma (child, 36 cases) 245±50mg/dl The mean value in chronic bronchitis was significantly higher than that in healthy group. 3) Pi phenotypes of 210 cases were MM. One patient with asthma revealed MS and another case with lung cancer revealed FM. It is suggested that abnormality of Pi system system was not the major cause of COPD in Japan on the base of the result in which we could not find any cases having Pi Z.