煤工尘肺患者肺通气功能障碍的影响因素

Influencing factors of pulmonary dysfunction in coal worker＇s pneumoconiosis

目的 分析煤工尘肺（CWP）患者肺功能障碍的可能影响因素。方法 采用病例-对照研究，分别选择141名CWP患者为病例组，200名非CWP的接尘矿工为接尘组，75名非从事接尘作业的健康者为对照组，均为男性。对研究对象调查接尘工种、接尘工龄、肺部疾病、吸烟及职业卫生防护情况等，并测定肺通气功能，根据对照人群特征建立相应肺功能指标的预计回归方程计算预计值，以各指标的实测值和预计值之比对肺功能障碍进行分型，采用非条件Logistic回归模型对影响因素进行分析。结果 病例组及接尘组FVC、FEV1.0实测值及FVC、FEV1.0实测值与其预测值的比值均明显低于对照组，差异有统计学意义（P〈0．05）；随煤工尘肺分级增加，限制性和混合性通气功能障碍发生率明显增高（χ^2=67．46，51．19，P〈0．05）；佩戴口罩情况、CWP分期、吸烟程度、接尘工龄等指标均被选入非条件Logistic回归模型。结论 影响煤工尘肺患者肺功能障碍的因素可能有CWP晋级、是否坚持佩戴口罩、吸烟、接尘工龄等。

Objective To investigate the possible influencing factors of pulmonary dysfunction in coal worker＇s pneumoconiosis （CWP）. Methods A total of 141 patients with CWP and 200 control miners with similar exposure histories but without apparent pulmonary disease or inflammation were interviewed with the detailed questionnaires （inchding histories of coal dust-exposure, smoking habits, alcohol consumption, protective mask uses,et al）. Lung function examinations were performed at the same time.Predicted formula of lung function index were established by the local healthy residents characteristics and the pulmonary dysfunction was classifted by the ratios between tested and predicted values. Results All parameters of lung function were significantly lower in CWP cases compared with that of control miners and the healthy controls （P〈0.05）.The main types of pulmonary dysfunction were restrictive and mixed ventilation disorders in CWP patients.The factors such as the category of CWP,the mask worn, the smoking quantity and exposure to coalmine dusts were included in the un- conditional logistic regression model. Conclusion The category of CWP, the usage of mask,the smoking and long duration exposure to coalmine dusts may be the main possible influencing factors of pulmonary dysfunction of CWP.Influencing factor analysis is given to inform choice of pertinence preventive measures.