Eibel R, Weber A, Stolpe S, Hellenbrand U, Bauer T
Institut für Klinische Radiologie, LMU München-Grosshadern, Germany.
Rofo. 2002 Jul;174(7):846-53. doi: 10.1055/s-2002-32698.
The complaints of patients suffering from pneumoconiosis and the decrease in cardio-respiratory function tests are related to the major complications, emphysema or bronchitis, resp. to a lesser degree the complaints are directly influenced by the silicotic process itself. Up to now, no large study has analysed the correlation of different types and severity of emphysema with the ILO-classification of pneumoconiosis in miners.
In 104 miners the severity of pneumoconiosis was classified by ILO. By HR-CT the type and severity of emphysema was analysed using a 4-point-scale. The correlation of emphysema with the ILO-classification was tested with Pearson-correlation.
The centrolobular emphysema was the dominant type with 59 %, but there was no dependence on the severity of pneumoconiosis. Only the paracicatricial emphysema had a significant correlation (p < 0.05) with the degree of large opacities. On the other hand, the paracicatricial emphysema was only detected in 32 %; under quantitative aspects it was seen to be less common than the centrolobular, the parapleural and the paraseptal emphysema (46 %). There was no significant correlation with the size and distribution of the small opacities and the different types of emphysema.
Only the large opacities had a significant correlation with the appearance of paracicatricial emphysema. The other types of emphysema, especially, the dominant centrolobular type had no obvious association with pneumoconiosis. The multifactoral genesis of emphysema has to be taken into account.
尘肺病患者的症状以及心肺功能测试结果的下降与主要并发症，即肺气肿或支气管炎有关，在较小程度上，这些症状也直接受矽肺病变本身的影响。到目前为止，尚无大型研究分析矿工中不同类型和严重程度的肺气肿与国际劳工组织（ILO）尘肺病分类之间的相关性。
对104名矿工的尘肺病严重程度按照国际劳工组织的标准进行分类。通过高分辨率计算机断层扫描（HR-CT），采用4分制分析肺气肿的类型和严重程度。用Pearson相关性检验肺气肿与国际劳工组织分类之间的相关性。
小叶中心型肺气肿最为常见，占59%，但与尘肺病的严重程度无关。只有瘢痕旁肺气肿与大阴影的程度有显著相关性（p<0.05）。另一方面，仅32%的患者检测出瘢痕旁肺气肿；从定量角度看，它比小叶中心型、胸膜旁型和间隔旁型肺气肿（46%）少见。小阴影的大小和分布与不同类型的肺气肿之间无显著相关性。
只有大阴影与瘢痕旁肺气肿的出现有显著相关性。其他类型的肺气肿，尤其是占主导地位的小叶中心型肺气肿与尘肺病无明显关联。必须考虑肺气肿的多因素成因。
