煤工尘肺和矽肺患者肺功能损伤及其影响因素

Pulmonary injury and its influencing factors in patients with coal worker's pneumoconiosis and silicosis

目的探讨煤工尘肺、矽肺患者各期肺功能损伤情况,分析尘肺期别、尘肺片小阴影密集度、小阴影分布肺区、阴影类型、吸烟、工龄对2种尘肺病肺功能的影响。方法对煤工尘肺、矽肺病例期别、工龄、是否吸烟进行分组,行统一的尘肺病X线胸片、肺功能测定,运用χ2检验、Spearman等级相关分析、独立样本t检验进行统计学分析。结果 1煤工尘肺、矽肺期别越高,肺功能异常率越高;煤工尘肺、矽肺各期别组间差异有统计学意义(P<0.01)。2煤工尘肺、矽肺X线胸片小阴影密集度、小阴影分布肺区与肺功能异常率呈正相关,Spearman等级相关分析rs值分别为0.943、0.986。3煤工尘肺和矽肺有大阴影和小阴影聚集者较仅有小阴影者肺功能异常率高(P<0.05)。4随着工龄的增加,肺功能异常率呈增长趋势,但组间未见统计学差异。5吸烟组和戒烟组较不吸烟组肺功能异常率升高(P<0.01)。结论尘肺病期别越高,肺功能异常率越高。煤工尘肺、矽肺患者小阴影密集度、小阴影分布肺区与肺功能异常率呈正相关。有大阴影和小阴影聚集者较仅有小阴影者对肺功能影响大。吸烟组和戒烟组的肺功能异常率高于不吸烟组。

[Objective]To study the pulmonary injury in patients with coal worker＇s pneumoconiosis and silicosis,analyze the effect of pneumoconiosis stage,density and distribution range of small opacities,type of opacities,smoking and working years on pulmonary function of two diseases.[Methods]The patients with coal worker＇s pneumoconiosis and silicosis were grouped according to disease stage,working years and smoking status,and received the chest Xi-ray and pulmonary function test. Chi square test,Spearman correlation analysis and independent sample t test were applied in the statistical analysis.[Results] 1The rate of abnormal lung function increased with increase of stage in pneumoconiosis and silicosis,and the differences were statistically significant among groups in different stages of pneumoconiosis and silicosis（P〈0.01）. 2 Among patients with coal worker＇s pneumoconiosis and silicosis,the density and distribution range of small opacities were positively correlated with rate of abnormal lung function,and the Spearman correlation analysis showed that rs value was 0.943 and 0.986 respectively. 3The rate of abnormal lung function in patients with both large and small opacities d was higher than that in those with small opacities only（P〈0.05）. 4The rate of abnormal lung function increased with age,and the difference was not statistically significant. 5The rate of abnormal lung function in smoking group and smoking cessation group was significantly higher than that in non-smoking group（P〈0.05）.[Conclusion]The patients in advanced pneumoconiosis stage have the higher rate of abnormal lung function. The density and distribution range of small opacities are positively correlated with the rate of abnormal lung function in patients with coal worker＇s pneumoconiosis and silicosis. The gathered large and small opacities have more obvious effect on lung function. The rate of abnormal lung function in smoking group and smoking cessation group is significantly higher than that in non-smoking group.