尘肺病患者肺功能及血气分析与临床表现的关系

Relationship between pulmonary function,blood gas analysis and clinical manifestations in patients with pneumoconiosis

目的探讨尘肺病患者肺功能及血气分析结果及其与临床症状的关系。方法根据肺功能和血气分析评定标准,对尘肺病患者的肺功能及血气测定结果进行分级,并分析肺功能损伤及血气分析结果与临床症状的关系。结果 139例尘肺病患者血气分析氧分压（PO2）与肺功能用力肺活量、第1秒用力通气量、1秒率、最大通气量实测值/预测值的百分比（FVC%、FEV（1.0）%、FEV1.0/FVC%、MVV%）4项指标异常率分别为33.09%、10.79%、15.83%、0.72%、23.74%,肺功能异常率Ⅰ期48.25%、Ⅱ期68.00%。Ⅱ期尘肺病患者低氧血症、肺功能4项指标以及肺功能异常高于Ⅰ期患者,其中FEV（1.0）%、MVV%差异有统计学意义（均P〈0.05）。患者30～39、40～49、50～55岁年龄组肺功能异常率分别为34.15%、55.68%和90.00%。胸闷、气短、无症状者分别占72.66%、69.78%、17.27%;肺功能血气分析监测异常、正常组呼吸困难患病率差异无统计学意义（P〉0.05）。结论尘肺病患者的肺功能异常随期别及年龄增长而增加,血气分析结果 PO2降低随尘肺期别升高而增多,患者缺氧症状（胸闷气短）与肺功能血气分析检出异常关联不明显,缺氧症状影响患者的劳动能力,在劳动能力鉴定中有参考价值。

[Objective] To explore the relationship between the pulmonary function,blood gas analysis results and clinical manifestations in patients with pneumoconiosis.[Methods]The results of pulmonary function and blood gas analysis in patients with pneumoconiosis were classified according to the evaluation criteria,and the relationship between pulmonary function,blood gas analysis results and clinical manifestations.[Results]Among 139 pneumoconiosis patients,the blood gas analysis index of partial pressure of oxygen（PO2）and four pulmonary function indexes of FVC%,FEV（1.0）%,FEV1.0/FVC% and MVV% was 33.09%,10.79%,15.83%,0.72% and 23.74%,respectively. The abnormal rate of pulmonary function in stage I and stage II patients was48.25% and 68.00% respectively. The rate of hypoxemia and abnormal pulmonary function,and the abnormal rates of four pulmonary function indexes among stage II patients were higher than those in stage I patients,and the differences in FEV（1.0）% and MVV% were statistically significant（P〈0.05）. The abnormal rate of pulmonary function in 30-39,40-49 and 50-55 year-old age group was 34.15%,55.68% and 90.00%,respectively. The proportion of patients with chest tightness,and shortness of breath was72.66% and 69.78% respectively,and 17.27% of patents had no symptoms. There was no statistically significant in the prevalence of dyspnea between the patents with abnormal results of pulmonary function and blood gas analysis and those with the normal results（P〈0.05）.[Conclusion]The rate of pulmonary function abnormalities in patients with pneumoconiosis increases with the disease stage and age,and rate of decreased PO2 increases with the disease stage. The hypoxic symptoms of（chest tightness,and shortness of breath） have no significant relationship with abnormal results of pulmonary function and blood gas analysis. The hypoxic symptoms can affect the patient＇s ability to work,which has a reference value in the identification of labor ability.