准确诊断肺气肿及其严重程度取决于从尸体解剖或剖胸肺活检所得肺组织的病理解剖表现。某些临床特征及肺功能测定结果虽可提示肺气肿,然唯有特殊X线表现及肺组织丧失弹性回缩力,才能有力地支持对患者在生前作出肺气肿诊断。作者对37例慢性阻塞性肺病患者进行研究,目的是了解测定肺最大弹性回缩压对诊断肺气肿的价值,及它与肺气肿X线检查结果的相互关系。根据X线检查肺气肿的表现,把本组37例分为三组,其中23例X线胸片正常。6例有局限性肺气肿,8例弥漫性肺气肿。结果发现肺容量增加及气体流速减慢在弥漫性肺气肿者最显著。血液气体分析表明休息时三组均有血氧低及二氧化碳含量正常,但运动时弥漫性肺气肿组 Accurate diagnosis of emphysema and its severity depends on the pathological anatomy of lung tissue obtained from autopsy or thoracotomy biopsy. Although some of the clinical features and lung function test results may indicate emphysema, only the special X-ray findings and loss of elastic retraction force of lung tissue can strongly support the diagnosis of emphysema in patients during their lifetime. The authors studied 37 patients with chronic obstructive pulmonary disease in order to understand the value of maximum elastic systolic blood pressure in the diagnosis of emphysema and its relationship to emphysema X-ray findings. According to the X-ray examination of emphysema performance, the group of 37 cases were divided into three groups, of which 23 cases of normal chest X-ray. Six patients had limited emphysema and eight had diffuse emphysema. The results showed that increased lung volume and gas flow slowed down in the most significant diffuse emphysema. Analysis of blood gases showed that both groups had low hypoxemia and normal levels of carbon dioxide at rest, but diffuse emphysema during exercise