Cao Lu, Zhang Xin-Gang, Wang Jian-Guo, Wang Han-Bin, Chen Yi-Bing, Zhao Da-Hui, Shi Wen-Fang, Xie Li-Xin
Department of Pulmonary and Critical Care Medicine, Chinese People's Liberation Army General Hospital, Beijing 100853, China.
Department of Nephrology, Affiliated Hospital of Military Medical Science Academy of the PLA, Beijing 100071, China.
J Thorac Dis. 2016 Nov;8(11):3160-3167. doi: 10.21037/jtd.2016.11.94.
This study aimed to determine the effects of smoke bomb-induced acute inhalation injury on pulmonary function at different stages of lung injury.
We performed pulmonary function tests (PFTs) in 15 patients with acute inhalation injury from days 3 to 180 after smoke inhalation. We measured the trace element zinc in whole blood on days 4 and 17, and correlations of zinc levels with PFTs were performed.
In the acute stage of lung injury (day 3), 3 of 11 patients with mild symptoms had normal pulmonary function and 8 patients with restrictive ventilatory dysfunction and reduced diffusing capacity. Some patients also had mild obstructive ventilatory dysfunction (5 patients) and a decline in small airway function (6 patients). For patients with severe symptoms, PFT results showed moderate to severe restrictive ventilatory dysfunction and reduced diffusing capacity. PaCO was significantly higher (P=0.047) in patients with reduced small airway function compared with those with normal small airway function. Whole blood zinc levels in the convalescence stage (day 17) were significantly lower than those in the acute stage (day 4). Zinc in the acute stage was negatively correlated with DCO/V on days 3, 10, and 46 (r=-0.633, -0.676, and -0.675 respectively, P<0.05).
Smoke inhalation injury mainly causes restrictive ventilatory dysfunction and reduced diffusing capacity, and causes mild obstructive ventilatory dysfunction and small airway function decline in some patients. Zinc is negatively correlated with DLCO/VA. Zinc levels may be able to predict prognosis and indicate the degree of lung injury.
本研究旨在确定烟雾弹所致急性吸入性损伤在肺损伤不同阶段对肺功能的影响。
我们对15例烟雾吸入后3天至180天的急性吸入性损伤患者进行了肺功能测试（PFTs）。在第4天和第17天测量全血中的微量元素锌，并对锌水平与PFTs进行相关性分析。
在肺损伤急性期（第3天），11例症状较轻的患者中，3例肺功能正常，8例有限制性通气功能障碍和弥散功能降低。部分患者还存在轻度阻塞性通气功能障碍（5例）和小气道功能下降（6例）。症状严重的患者，PFT结果显示为中度至重度限制性通气功能障碍和弥散功能降低。小气道功能降低的患者PaCO显著更高（P=0.047），与小气道功能正常的患者相比。恢复期（第17天）全血锌水平显著低于急性期（第4天）。急性期的锌在第3天、第10天和第46天与DCO/V呈负相关（r分别为-0.633、-0.676和-0.675，P<0.05）。
烟雾吸入性损伤主要导致限制性通气功能障碍和弥散功能降低，并在部分患者中导致轻度阻塞性通气功能障碍和小气道功能下降。锌与DLCO/VA呈负相关。锌水平可能能够预测预后并提示肺损伤程度。
