摘要
目的探究矽肺合并进行性大块纤维化(PMF)患者肺功能受损的特征及相关危险因素。方法选取2014年6月至2020年10月于首都医科大学附属北京朝阳医院职业病与中毒医学科住院治疗的矽肺合并PMF患者共115例,按照肺通气功能分为正常组、阻塞组、限制组及混合组,应用胸部高分辨CT(HRCT)对大阴影位置、面积及肺气肿分级进行评估,其中大阴影位置分为中央型、周围型和混合型。结果115例患者中,85例(73.91%)存在不同类型的肺通气功能受损,其中阻塞组36例(31.30%)、限制组9例(7.83%)、混合组40例(34.78%);根据大阴影位置分为中央型41例(35.65%)、周围型52例(45.22%)、混合型22例(19.13%)。logistic回归分析显示,中央型大阴影和3-4级肺气肿是阻塞性通气功能障碍的危险因素(OR=52.179、5.500,P<0.05);C类大阴影面积是限制性通气功能障碍的危险因素(OR=33.146,P<0.05);B类、C类大阴影面积和中央型大阴影为混合性通气功能障碍的危险因素(OR=6.414、11.561、19.600、P<0.05)。结论矽肺合并PMF患者肺通气功能障碍发生率较高,以阻塞及混合性通气功能障碍为主;大阴影面积和位置与肺通气功能障碍的发生及类型密切相关。
Objective To investigate the characteristics of and associated risk factors for pulmonary dysfunction in silicosis patients with progressive massive fibrosis(PMF).Methods In-patients with PMF treated in the Department of Occupational Medicine and Toxicology in Beijing Chao-Yang Hospital,Capital Medical University from June 2014 to October 2020 were enrolled in this study.Based on their pulmonary ventilation function,the patients were divided into normal ventilation group,obstructive ventilation dysfunction group,restrictive ventilation dysfunction group,and mixed ventilation dysfunction group.The location and area of the large opacity and the grade of emphysema were evaluated by high-resolution CT(HRCT)of the chest.Based on the location,the large opacity was classified into central type,peripheral type,and mixed type.Results A total of 115 silicosis patients with PMF were enrolled,with 85(73.91%)having different types of pulmonary dysfunction,including 36 cases(31.30%)in the obstructive ventilation dysfunction group,9 cases(7.83%)in the restrictive ventilation dysfunction group and 40 cases(34.78%)in the mixed ventilation dysfunction group.As for the location of the large opacity,41 cases(35.65%)were central type,52 cases(45.22%)were peripheral type,and 22 cases(19.13%)were mixed type.Logistic regression analysis showed that the central large opacity and grade 3-4 emphysema were risk factors for obstructive ventilation dysfunction(OR=52.179,5.500,P<0.05),class C large opacity was the risk factor for restrictive ventilation dysfunction(OR=33.146,P<0.05),class B,class C large opacity and central large opacity were the risk factors for mixed ventilation dysfunction(OR=6.414,11.561,19.600,P<0.05).Conclusion In silicosis patients with PMF,the incidence rate of pulmonary ventilation dysfunction is higher,mainly obstructive and mixed ventilation dysfunction.The area and location of large opacity are associated with the incidence and types of pulmonary ventilation dysfunction.
作者
余诗雯
李安
宋玉果
Yu Shiwen;Li An;Song Yuguo(Department of Occupational Medicine and Toxicology,Beijing Chao-Yang Hospital,Capital Medical University,Beijing 100020,China)
出处
《中华劳动卫生职业病杂志》
CAS
CSCD
北大核心
2021年第11期831-835,共5页
Chinese Journal of Industrial Hygiene and Occupational Diseases
关键词
矽肺
进行性大块纤维化
大阴影
肺功能
高分辨CT
危险因素
Silicosis
Progressive massive fibrosis
Large opacity
Pulmonary function
High resolution CT
Risk factors
