Shi Jin, Mao Ling, Chen Zidan, Zhou Shaowei, Bian Luqin, Sun Daoyuan
Shanghai Pulmonary Hospital , Tongji University School of Medicine, Shanghai 200433, China.
Shanghai Pulmonary Hospital , Tongji University School of Medicine, Shanghai 200433, China; E-mail:
Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2015 Nov;33(11):826-9.
To study the character of welder's pneumoconiosis on CT, pathology, and lung function.
To contrast 185 welder's pneumoconiosis and 115 silicosis on CT, pathology, and clinical characters which were diagnosed between Jan 2008 and Dec 2013. Chest X-ray and lung function of 39 welder's pneumoconiosis patients were followed up after diagnosed 4~6 years later.
Average age and working years of welder's pneumoconiosis were 36.7 and 11.5, less than silicosis patients 58.8 and 22.1, respectively (P<0.05). Of all 185 welder's pneumoconiosis 98.4% were of stage I and no stage III, while in silicosis group stage I, stage II and stage III were 56.5%, 22.6% and 20.9%, respectively. The ratio differences between the two groups were statistically significant,P<0.05. 82.7% of welder's pneumoconiosis patients were observed pathologically moderate or above dust deposition in lung tissue while interstitial fibrosis level was just mild (97.6% patients) or no fibrosis (2.4% patients). By contrast, 60.0% silicosis patients pathologically showed moderate or above dust deposition while 77.8% were of moderate or above fibrosis. CT findings in welder' s pneumoconiosis were diffuse branching linear structure (38.9%), low density consistent size centrilobular micronodules (19.5%), or both (30.8%). Poorly-defined ground-glass attenuation centrilobular micronodules or widely ground glass shadow were observed in 6.4% welder's pneumoconiosis patents. 30.8% patients failed to reach the original stage when 39 welder's pneumoconiosis followed up chest radiograph.
Changes in welder's lung caused by welding fume were not only siderosis, but also interstitial fibrosis.
研究电焊工尘肺在CT、病理学及肺功能方面的特点。
对比2008年1月至2013年12月期间诊断的185例电焊工尘肺和115例矽肺患者的CT、病理学及临床特征。对39例电焊工尘肺患者在确诊4至6年后进行胸部X线及肺功能随访。
电焊工尘肺患者的平均年龄和工作年限分别为36.7岁和11.5年,低于矽肺患者的58.8岁和22.1年(P<0.05)。185例电焊工尘肺患者中98.4%为Ⅰ期,无Ⅲ期;而矽肺组中Ⅰ期、Ⅱ期和Ⅲ期分别为56.5%、22.6%和20.9%。两组间比例差异有统计学意义,P<0.05。82.7%的电焊工尘肺患者肺组织病理观察可见中度及以上粉尘沉积,而间质纤维化程度仅为轻度(97.6%患者)或无纤维化(2.4%患者)。相比之下,60.0%的矽肺患者病理显示中度及以上粉尘沉积,77.8%为中度及以上纤维化。电焊工尘肺的CT表现为弥漫性分支线状结构(38.9%)、密度一致的小叶中心性低密度微结节(19.5%)或两者皆有(30.8%)。6.4%的电焊工尘肺患者可见边界不清的小叶中心性磨玻璃样微结节或广泛磨玻璃影。39例电焊工尘肺患者随访胸部X线时,30.8%的患者未达到原期别。
电焊烟尘所致电焊工肺部改变不仅有铁末沉着症,还有间质纤维化。