The lungs can be divided into two parts: the pulmonary parenchyma and the pulmonary interstitium. The lung parenchyma is the site of gas exchange where oxygen is taken in and carbon dioxide (carbon dioxide) is expelled from the body; it is the part that is exposed to air. In contrast, the pulmonary interstitium refers to the skeletal part of the lung that forms the site of gas exchange through connective tissue etc. (Figure "Morphology of alveoli (schematic diagram of alveolar walls)"). A typical disease that occurs in the lung parenchyma is bacterial pneumonia, which is caused by bacteria, and what is commonly referred to as "pneumonia" is a disease caused by this type of infection. On the other hand, interstitial pneumonia is a disease in which inflammation occurs mainly in the interstitium of the lungs for some reason, and over time, the fibrous components of the interstitium gradually increase, causing a lesion known as fibrosis, which causes the tissue to lose its flexibility, mainly in the interstitium. Interstitial pneumonia develops suddenly and progresses rapidly, causing the lungs to lose flexibility and lung capacity and other lung functions to decline, resulting in insufficient oxygen intake into the body and respiratory failure. This type of progression is called acute interstitial pneumonia. There is also a type of interstitial pneumonia in which inflammation is persistent in the pulmonary interstitium over a long period of time and fibrosis progresses slowly; this type of condition is called idiopathic pulmonary fibrosis or idiopathic interstitial pneumonia. The name idiopathic pulmonary fibrosis focuses on fibrosis, which is the end stage of inflammatory lesions, and is a name that is commonly used in other countries. On the other hand, the term idiopathic interstitial pneumonia is used primarily in Japan and is intended to capture the pathology centered on the state of inflammation in the lungs. The onset and progression of symptoms of idiopathic pulmonary fibrosis (idiopathic interstitial pneumonia) vary from person to person, but generally occur very slowly. Source: Shogakukan Home Medical Library Information |
肺は、肺実質(はいじっしつ)と肺間質(はいかんしつ)の2つに分けることができます。 肺実質とは、酸素を体内に取り込んだり、二酸化炭素(炭酸ガス)を体外へ排出するガス交換の場のことで、空気にふれている部分です。 これに対して肺間質とは、結合組織などによって、そのようなガス交換の場を形成している、肺の骨格的な部分をいいます(図「肺胞の形態(肺胞壁の模式)」)。 肺実質におこる病気としては、細菌が原因となって発病する細菌性肺炎(さいきんせいはいえん)が代表的なもので、ふつう「肺炎」といっているのは、こうした感染によっておこる病気です。 一方、間質性肺炎は、なんらかの原因で、主として肺の間質に炎症がおこり、時間の経過とともに、だんだんに間質の線維成分が増えて、いわゆる線維化(せんいか)という、組織の柔軟性が失われる病変が、間質を中心におこってくる病気です。 間質性肺炎には、突然発病し、急激に進行して肺の柔軟性が失われ、肺活量など、肺の機能が低下して、その結果、酸素の体内への取り込み不足、呼吸不全(こきゅうふぜん)といった病態になることがあります。このような経過をとるものを、急性間質性肺炎(きゅうせいかんしつせいはいえん)といいます。 また、肺間質に長い期間にわたり持続的に炎症がみられ、線維化がゆっくりと進むタイプの間質性肺炎もあって、こういう病態を示すものを、特発性肺線維症(とくはつせいはいせんいしょう)、あるいは特発性間質性肺炎(とくはつせいかんしつせいはいえん)と呼んでいます。 特発性肺線維症という病名は、炎症性病変の終末像である線維化に焦点をあてたものであり、諸外国でよく用いられている病名です。 一方、特発性間質性肺炎という病名は、肺の炎症のようすを中心に病態をとらえようとするもので、おもに日本で使われています。 この特発性肺線維症(特発性間質性肺炎)の発症や症状の進行は、個人差があるものの、一般的には、非常にゆっくりとしたものです。 出典 小学館家庭医学館について 情報 |
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