矽肺患者肺功能与动脉血气分析的研究

Study on Pulmonary Function and Arterial Blood gas Analysis in Silicotic Patients

本文对88例矽肺病人和37名接尘工人进行了肺功能和动脉血气分析,结果表明各期矽肺的VC、FVC、FEV_1、MMF、FEV_1/FVC均值低于接尘组,而异常检出率则高于接尘组,通气功能的下降呈进行性,但早期不很明显,与接尘组无显著差异。各期矽肺组V_(50)及V_(25)均有明显降低,显示早期即有小气道的广泛损害。矽肺的通气功能损害类型,Ⅰ期矽肺组以阻塞型多见,Ⅱ、Ⅲ期矽肺组以混合型为主。RV和RV/TLC在Ⅲ期矽肺组有明显增高,表明矽肺晚期多并发肺气肿。另外DL_(CD)和K_(CD)在各矽肺组均低于接尘组,差异有显著性,说明矽肺早期即可有弥散功能的损害。血气分析表明PaO_2及SatO_2降低主要见于Ⅱ、Ⅲ期矽肺。Ⅲ期矽肺组有1/3患者(33.33％)在有低氧血症的同时合并有高碳酸血症。对比肺功能和血气分析结果,认为通气功能指标FEV_1、FEV_1/FVC、VC、FVC、MMF以及弥散功能指标DL_(CO)和K_(CO)为早期反映矽肺呼吸功能的灵敏指标。血气分析对病情和预后的判断有重要参考价值。

The pulmonary function and alterial blo-od gas analysis of 77 silicotic patients and 33workers exposed to silicotic dust (control gro-up) were measured. The results showed thatthe mean values of VC, FVC,FEV_1, MMF,FEV_1/FVC in silicotic patients group werelower than those in control group. The vent-ilatory function in silicotic patients group wasdecreased progressively, but it was not obvi-ous in early stage. V_(50) and V_(25) were great-ly decreased in all category of silicotic patients. The dominant impairment in silicoticpatients of category I was of obstructive patt-ern, but the mixed pattern was found mostlyin silicotic patients of category Ⅲ. RV and RV/TLC were significantly incr-eased in silicotic patients of category Ⅲ. DL_(co)and K_(co) in silicotic patients group were lowerthan those of control group. The arterial blo-od gas analysis showed that the decrease ofPaO_2 and SatO_2 mostly found in silicotic pa-tients of category Ⅱ,Ⅲ One-Third of patientsin category Ⅲ had both hypoxemia and hyp-ercapnia. In conclution we conridec thatFEV_1, FEV_1/FVC, VC, FVC, MMF, DL_(co) K_(co)are sensitive indices which could demonstrateearly changes of lung function in silicotic pa-tients, the arterial blood gas analysis haveimportant referential value for disease statusand prognosis of silicotic patients.