与尘肺病合并轻度支气管阻塞的煤矿工人呼吸困难临床分级相关的功能变量。

Functional variables associated with the clinical grade of dyspnoea in coal miners with pneumoconiosis and mild bronchial obstruction.

作者信息

Bauer T T, Schultze-Werninghaus G, Kollmeier J, Weber A, Eibel R, Lemke B, Schmidt E W

机构信息

Berufsgenossen- schaftliche Kliniken Bergmannsheil, Abteilung für Pneumologie, Allergologie und Schlafmedizin, Medizinische Klinik und Poliklinik, Bürkle-de-la-Camp- Platz 1, D-44789 Bochum, Germany.

出版信息

Occup Environ Med. 2001 Dec;58(12):794-9. doi: 10.1136/oem.58.12.794.

DOI:10.1136/oem.58.12.794

PMID:11706146

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1740081/

Abstract

OBJECTIVES

Dyspnoea is a common symptom in coal miners with pneumoconiosis. Among others, gas exchange disturbances due to airway obstruction or mismatch between ventilation and perfusion may be underlying mechanisms. The validation of dyspnoea by the degree of airway obstruction is controversial, because the extent of airway obstruction often does not correlate with the clinical grade of breathlessness.

METHODS

The association was investigated between breathlessness (self reported, on a six point scale) and indices of submaximal spiroergometry in 66 coal workers with radiographically confirmed pneumoconiosis (International Labour Organisation (ILO) grade of profusion > or =1/0, mean (SD) age 64 (5.5) years, mean (SD) forced expired volume in 1 second (FEV(1)) 77.5 (22.9) % predicted).

RESULTS

The clinical degree of breathlessness was independently associated with minute ventilation/oxygen consumption (VE/VO(2)) ratio (beta 0.423, 95% confidence interval (95% CI) 0.18 to 0.67, p=0.001) and smoking (beta 0.318, 95% CI 0.21 to 1.79, p=0.014) in a multiple linear regression analysis. The VE/VO(2) ratio (beta 0.556, 95% CI 0.20 to 0.90, p=0.003) was also the best predictor of breathlessness when only coal miners with airway obstruction (FEV(1) < 80% predicted) were analyzed.

CONCLUSION

The VE/VO(2) ratio as a measurement of mismatch between ventilation and perfusion predicted the clinical grade of breathlessness better than measurements of bronchial obstruction at rest in coal workers with pneumoconiosis.

摘要

目的

呼吸困难是尘肺病煤矿工人的常见症状。其中，气道阻塞或通气与灌注不匹配导致的气体交换障碍可能是潜在机制。通过气道阻塞程度来验证呼吸困难存在争议，因为气道阻塞程度往往与临床呼吸困难分级不相关。

方法

对66名经影像学确诊为尘肺病的煤矿工人（国际劳工组织（ILO） profusion分级≥1/0，平均（标准差）年龄64（5.5）岁，平均（标准差）一秒用力呼气容积（FEV₁）为预测值的77.5（22.9）%）进行了呼吸困难（自我报告，采用六点量表）与次极量运动心肺功能测试指标之间关联的研究。

结果

在多元线性回归分析中，呼吸困难的临床程度与分钟通气量/氧耗量（VE/VO₂）比值（β 0.423，95%置信区间（95%CI）0.18至0.67，p = 0.001）和吸烟（β 0.318，95%CI 0.21至1.79，p = 0.014）独立相关。在仅分析气道阻塞（FEV₁<预测值的80%）的煤矿工人时，VE/VO₂比值（β 0.556，95%CI 0.20至0.90，p = 0.003）也是呼吸困难的最佳预测指标。