尘肺合并慢性阻塞性肺疾病的回顾性分析

Retrospective Analysis of Pneumoconiosis Complicated with COPD

目的研究尘肺患者慢性阻塞性肺疾病(COPD)的合并率,以及尘肺期别、结核、吸烟、年龄对合并COPD的影响。方法回顾2008年9月—2009年5月在我院住院的292例尘肺患者COPD的合并率,在入院时对其进行支气管舒张试验,凡吸入沙丁胺醇后15min用力呼气容积/用力肺活量(FEV1/FVC)<70%,并排除其他不完全可逆气流受限疾病即诊为尘肺合并COPD。结果尘肺患者COPD合并率为12.33%,尘肺随着期别的增加,合并COPD率也增高,尘肺Ⅲ期合并COPD率高达34.29%。尘肺结核COPD合并率26.15%,明显高于无结核组,差异有统计学意义(χ2=14.79,P<0.01)。有吸烟史烟尘肺合并COPD率与无吸烟史组差异无统计学意义(χ2=1.23,P>0.05)。尘肺患者随着年龄的增加合并COPD率有增高的趋势,70岁以上尘肺合并COPD率高达21.31%。结论尘肺合并COPD率明显高于全国平均水平,职业性粉尘与结核是尘肺合并COPD的危险因素。

[Objective]To investigate the incidence rate of chronic obstructive pulmonary disease （COPD） in pneumoconiosis patients,discuss the effect of the pneumoconiosis level,tuberculosis,smoking and age on pneumoconiosis complicated with COPD.[Methods]The incidence rate of COPD among 292 inpatients with pneumoconiosis in our hospital from September 2008 to May 2009 was analyzed retrospectively. According to the bronchodilation test performed in the patients on admission,excluding other diseases of non-fully reversible airflow limitation,FEV1/FVC less than 70% in 15 minutes after salbutamol inhalation was used as diagnostic criteria of pneumoconiosis complicated with COPD.[Results]The incidence rate of pneumoconiosis complicated with COPD was 12.33%,which increased with increase of the pneumoconiosis level,and the incidence rate of COPD reached 34.29% among patients with level Ⅲ pneumoconiosis. The incidence rate of pneumoconiosis complicated with COPD in the tuberculosis group was higher than that in non-tuberculosis group significantly （χ2=14.79,P0.01）,and there was no significant different between the smoking group and the non-smoking group （χ2=1.23,P0.05）.The incidence rate of pneumoconiosis complicated with COPD increased with age,that of patients above 70 years old reached 21.31%.[Conclusion]The incidence rate of pneumoconiosis complicated with COPD in our hospital is obviously higher than the national average level. Occupational dust and tuberculosis are the hazard factors of pneumoconiosis complicated with COPD.