职业性接触粉尘工人不同结局的肺通气功能比较

Comparison of pulmonary function among workers with different outcomes due to exposure todust

目的比较职业性接触粉尘导致的不同结局工人肺通气功能及小气道损伤状况,为早期诊断职业性呼吸疾患提供依据。方法选取某矿煤工尘肺患者80例,尘肺合并结核33例,以及无尘肺矿工177例为接触粉尘后的三种不同结局。分别测定各结局对象的肺功能,指标包括FVC、FEV1、FEV1/FVC、V50、V25、MMEF,以实测值占预计值百分比进行比较分析。结果比较各组肺功能各指标实测值占预计值的百分比,尘肺合并结核组各指标显著低于其他两组(P<0.01),单纯尘肺组在FVC%、FEV1%和FEV1/FVC%上损伤分级均属正常(>80%);各组肺通气功能损伤级别构成差异有统计学意义(P<0.01),其中尘肺合并结核组肺功能在中重度损伤的比例显著高于其他组,而无尘肺组正常的肺功能级别比例显著高于其余两组(P<0.01)。小气道指标(V50%,V25%)在尘肺合并结核组和尘肺组显著减低。结论职业性接触粉尘导致的尘肺及尘肺合并结核肺通气功能显著减低;小气道功能对职业性接触粉尘肺功能损伤较敏感,对职业性接触粉尘工人有早期预警作用。

Objective To compare pulmonary function and small airway situation among workers with different outcomes due to dust exposure in order to provide references for early diagnosis of occupational respiratory diseases.Methods With three different outcomes due to exposure to dust in a coal mine,80 cases of silicosis,33 cases of silicosis combined with tuberculosis（TB） and 177 cases of healthy workers were enrolled into the study.Lung function was measured for the indicators of FVC,FEV1,V50,V25,and MMEF.Results The percentage（measured value/expected value） of silicosis combined with TB was the lowest among the three groups（P0.01）.FVC%,FEV1% and FEV1/FVC% were above 80% in the silicosis workers,and rated to normal according the lung function injury rating criteria.There existed significant differences in lung function rating ratio among the three groups.Silicosis combined with TB workers composed higher ratios in serious lung function injury rating than others,and healthy workers composed higher that of normal rating than others（P0.01）.Small airway function（V50%,V25%） declined greatly in silicosis and silicosis combined with TB workers.Conclusion Lung function declines greatly in silicosis and silicosis combined with TB workers.Small airway function indicators are sensitive to lung function injury among workers exposed to dust,and suitable for early warning.