重庆市253例无尘肺接尘工人肺功能分析

Analysis on pulmonary function of 253 dust-exposed workers without pneumoconiosis in Chongqing

目的研究接尘工人在胸片未达到Ⅰ期尘肺诊断标准前,肺功能改变情况。方法采用回顾性分析,对2019年经重庆市职业病防治院确诊为"无尘肺"病例253例,按照胸片影像学改变分为2组,无改变为"0期"组;有改变,但达不到Ⅰ期尘肺诊断标准为"0+期"组,分析2组病例在年龄、接尘工龄和粉尘性质等因素影响下肺功能改变情况。结果 2组病例肺功能改变程度差异有统计学意义(P<0.05),"0+期"组肺功能损伤较重。"0期"组不同接尘工龄工人第1 s用力呼气容积(FEV1)、1 s率(FEV1/FVC%)比较,差异均有统计学意义(均P<0.05),用力肺活量(FVC)比较差异无统计学意义(P>0.05);"0+期"组不同接尘工龄工人FVC、FEV1、FEV1/FVC%比较,差异均无统计学意义(均P>0.05),接尘工龄越长FEV1平均值越低,肺功能损伤程度越重。"0+期"不同年龄组工人FVC、FEV1、FEV1/FVC%比较,差异均有统计学意义(均P<0.05)";0期"不同年龄组工人FVC、FEV1、FEV1/FVC%比较,差异均无统计学意义(均P>0.05),年龄越大FEV1平均值越低。不同粉尘性质分类,分别比较肺功能改变和胸片改变,差异均无统计学意义(均P>0.05)。50.2%(127例)的接尘工人胸片未达到Ⅰ期尘肺诊断标准前肺功能已发生一定程度的损伤。结论肺功能损伤受胸片改变程度、接尘工龄及年龄的影响,胸片改变及肺功能改变与粉尘性质无明显联系。

Objective To study the pulmonary function change of dust-exposed workers whose chest X-ray results do not reach the diagnostic standard of stage I pneumoconiosis. Methods By retrospective analysis,253 cases that were diagnosed as "pneumoconiosis-free"by the Chongqing Occupational Disease Prevention Hospital in 2019 were divided into two groups according to the changes of chest radiograph. The cases without changes were regarded as "stage 0" group,and those who had the changes but the results do not reach the diagnostic standard of stage I pneumoconiosis were regarded as "stage 0+" group. The lung function change in the two groups were analyzed under the influence of age,dust exposure working age,dust nature and other factors. Results There was statistically significant difference in the change degree of lung function between the two groups(P<0.05),and the lung function injury in the "stage 0+" group was serious. In "stage 0" group,there were statistically significant differences in the forced expiratory volume in the first second(FEV1) and FEV1/FVC% among workers with different dust exposure working age(all P<0.05),while the difference in the forced vital capacity(FVC) was not statistically significant(P>0.05). In "stage 0+" group,there were no statistically significant differences in FVC,FEV1 and FEV1/FVC% among workers with different dust exposure working age(all P>0.05). The longer the workers were exposed to dust,the lower the average FEV1,and the more severe the lung function injury.In "stage 0" group,there were statistically significant differences in the FVC,FEV1 and FEV1/FVC% among different age groups(P<0.05). In "stage 0+" group,there were no statistically significant differences in FVC,FEV1 and FEV1/FVC% among different age groups(all P>0.05). The older the age,the lower the average FEV1. There were no statistically significant differences in lung function changes and chest X-ray changes among different dust nature groups(all P>0.05). 50.2%(127 cases) of the dustexposed workers had the lung function damage to some extent before the chest X-ray results reached the diagnostic standard of stage I pneumoconiosis. Conclusion The lung function injury is affected by the degree of chest X-ray changes,length of dust exposure and age. The chest X-ray changes and lung function changes are not related to the nature of dust.