3种主要尘肺的死因病谱及其变化趋势

The disease spectrum of death cause as well as its change trend for three main patterns of pneumoconiosis

目的 :为揭示 3种常见尘肺即矽肺、煤工尘肺和石棉肺的死因病谱及其变化趋势。方法 :以 1949～ 1998年四川省尘肺病监测系统中的病例为基础 ,对自 6 0年代以来 1391例死亡病例作死因分析。结果 :在前 3位死因中 ,矽肺患者为尘肺 (即慢性呼吸功能衰竭 )、肺炎和肺结核 ,煤工尘肺患者为尘肺、慢性肺心病和其它疾病 ,石棉肺患者为慢性肺心病、其它疾病和肺恶性肿瘤。不同类型的尘肺死因的构成变化趋势不相同 ,死于呼吸系统疾病的患者比例在矽肺和石棉肺中呈明显下降趋势 ,而在煤工尘肺中则呈上升趋势 ;石棉肺和煤工尘肺中死于恶性肿瘤的患者比例均呈现下降趋势。结论 :3种尘肺死因病谱不尽相同 ,不同年代间亦有一定差异。应积极防治尘肺患者呼吸系统尤其是慢性呼吸功能衰竭。

Objective To unveil the disease spectrum of the death cause as well as its change trend for silicosis,asbestosis and coal worker′s pneumoconiosis.Methods Based on the pneumoconiosis cases reported from The Surveillance System of Pneumoconiosis of Sichuan Provine during 1949 to 1998,1 391 death cases died since 1960s were analyzed.Results Of the first three leading death diseases,the silicosis were chronic respiratory failure,pneumonia and pulmonary tuberculoss;the coal worker′s pneumoconiosis were chronic respiraotory failure,cor pulmonale and other diseases;the asbestosis were cor pulmonale,other diseases and malignant lung tumours.There were different trends of the death constitutional proportions for different patterns of pneumoconiosis.For silicosis and asbestosis,the proportion died from pulmonary diseases declined obviously,but for coal worker′s pneumoconiosis,the proportion increased.The proportion died from malignant lung tumours appeared a decrease trend both for asbestosis and coal worker′s pneumoconiosis.Conclusion There were some different death constitutions for the three main pneumoconiosis.It was most imprtant to prevent and cure pulmonary co current diseases such as chronic respiratory failure,cor pulmonale and pulmonary tuberculosis for pneumoconiosis in clinical practice.