Cancers and Populations, ERI3 INSERM, Faculty of Medicine, Caen University Hospital, Caen, France.
Thorax. 2011 Nov;66(11):985-91. doi: 10.1136/thoraxjnl-2011-200172. Epub 2011 Jul 1.
It is uncertain whether isolated pleural plaques cause functional impairment.
To analyse the relationship between isolated pleural plaques confirmed by CT scanning and lung function in subjects with occupational exposure to asbestos.
The study population consisted of 2743 subjects presenting with no parenchymal interstitial abnormalities on the high-resolution CT (HRCT) scan. Asbestos exposure was evaluated by calculation of an individual cumulative exposure index (CEI). Each subject underwent pulmonary function tests (PFTs) and HRCT scanning. Variables were adjusted for age, smoking status, body mass index, CEI to asbestos and the centres in which the pulmonary function tests were conducted.
All functional parameters studied were within normal limits for subjects presenting with isolated pleural plaques and for those presenting with no pleuropulmonary abnormalities. However, isolated parietal and/or diaphragmatic pleural plaques were associated with a significant decrease in total lung capacity (TLC) (98.1% predicted in subjects with pleural plaques vs. 101.2% in subjects free of plaques, p=0.0494), forced vital capacity (FVC) (96.6% vs. 100.4%, p<0.001) and forced expiratory volume in 1 s (FEV(1)) (97.9% vs. 101.9%, p=0.0032). In contrast, no significant relationship was observed between pleural plaques and FEV1/FVC ratio, forced expiratory flow at 25-75% FVC and residual volume. A significant correlation was found between the extent of pleural plaques and the reduction in FVC and TLC, whereas plaque thickness was not related to functional impairment.
The results show a relationship between isolated parietal and/or diaphragmatic pleural plaques and a trend towards a restrictive pattern, although the observed decrease in FVC and TLC is unlikely to be of real clinical relevance for the majority of subjects in this series.
目前尚不确定孤立性胸膜斑是否会导致功能障碍。
分析 CT 扫描证实的孤立性胸膜斑与职业性石棉暴露人群的肺功能之间的关系。
研究人群由 2743 名高分辨率 CT（HRCT）扫描未见肺实质间质异常的受试者组成。通过计算个体累积暴露指数（CEI）评估石棉暴露情况。所有受试者均接受肺功能检查（PFTs）和 HRCT 扫描。调整了年龄、吸烟状况、体重指数、CEI 至石棉以及进行肺功能检查的中心等变量。
所有研究的功能参数均在孤立性胸膜斑和无胸膜肺异常的受试者中处于正常范围。然而，壁层和/或膈肌孤立性胸膜斑与总肺容量（TLC）显著降低相关（胸膜斑受试者为 98.1%预测值，无胸膜斑受试者为 101.2%，p=0.0494）、用力肺活量（FVC）（96.6% vs. 100.4%，p<0.001）和 1 秒用力呼气量（FEV（1））（97.9% vs. 101.9%，p=0.0032）。相比之下，胸膜斑与 FEV1/FVC 比值、25-75%FVC 时呼气流量和残气量之间无显著相关性。胸膜斑的严重程度与 FVC 和 TLC 的降低呈显著相关，而胸膜斑厚度与功能障碍无关。
结果表明，壁层和/或膈肌孤立性胸膜斑与限制性模式之间存在相关性，尽管在该系列中大多数受试者中观察到的 FVC 和 TLC 下降不太可能具有真正的临床意义。
