Li X, Dai W R, Li L, Liu W F, Yang Z X, Xie L
Hunan Institute of Occupational Disease Prevention and Treatment.
Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2017 Nov 20;35(11):865-867. doi: 10.3760/cma.j.issn.1001-9391.2017.11.018.
To investigate the clinical features of pneumoconiosis complicated with pulmo-nary emphysema. selected 868 patients with pneumoconiosis were selected from December 2015 to December 2016 in Hunan occupational disease prevention and treatment hospital. Collected the results of high-resolution spiral CT, arterial blood gas, ECG, pulmonary function and MRC score. The subjects were divided into pneumoconiosis complicated with pulmonary emphysema group and simple pneumoconiosis group accord-ing to the results of HRCT. The smoking, MRC score, pulmonary function, blood gas and complications were compared. A total of 868 patients were enrolled in the study. Emphysema 232 people, accounting for 26.73%. The incidence of emphysema in the first phase of pneumoconiosis was 12.69%, and the incidence rate of emphysema in pneumoconiosis was 17.03%, The incidence of three Stage pneumoconiosis was highest, up to 60.76%, the incidence of emphysema increased with the increase of stages of pneumoconiosis (=0.000) .The smoking index of pneumoconiosis combined with emphysema group was significantly higher than that of simple pneumoconiosis group (<0.01) . The MRC score of pneumoconiosis complicated with pulmonary em-physema group was higher than that of simple pneumoconiosis group (=0.000) . In pneumoconiosis complicat-ed with pulmonary emphysema group the FEV(1.0)%, FVC%, FEV(1.0)/FVC, DLCO%, oxygen partial pressure were significantly lower than that of simple pneumoconiosis group (≤0.05) . The combined rate of Bullae of lung in pneumoconiosis complicated with pulmonary emphysema group was higher than that of simple pneumo-coniosis group (<0.01) . pneumoconiosis stage and smoking. Patients with pneumoconiosis com-plicated with pulmonary emphysema had heavier breathing difficulties, more serious pulmonary function and active endurance, the degree of hypoxia is more serious, and had a higher incidence of complications. The pul-monary function of pneumoconiosis complicated with pulmonary emphysema is not consistent with the typical CPFE.
为探讨尘肺病合并肺气肿的临床特征。选取2015年12月至2016年12月在湖南省职业病防治院就诊的868例尘肺病患者,收集其高分辨率螺旋CT、动脉血气、心电图、肺功能及MRC评分结果。根据HRCT结果将研究对象分为尘肺病合并肺气肿组和单纯尘肺病组,比较两组吸烟情况、MRC评分、肺功能、血气及并发症情况。本研究共纳入868例患者,其中肺气肿患者232例,占26.73%。尘肺病一期肺气肿发生率为12.69%,尘肺病二期肺气肿发生率为17.03%,尘肺病三期肺气肿发生率最高,达60.76%,肺气肿发生率随尘肺病期数增加而升高(P=0.000)。尘肺病合并肺气肿组吸烟指数显著高于单纯尘肺病组(P<0.01)。尘肺病合并肺气肿组MRC评分高于单纯尘肺病组(P=0.000)。尘肺病合并肺气肿组FEV(1.0)%、FVC%、FEV(1.0)/FVC、DLCO%、氧分压均显著低于单纯尘肺病组(P≤0.05)。尘肺病合并肺气肿组肺大疱合并率高于单纯尘肺病组(P<0.01)。尘肺病合并肺气肿患者呼吸困难更重,肺功能及活动耐力更差,缺氧程度更严重,并发症发生率更高。尘肺病合并肺气肿的肺功能表现与典型的CPFE不一致。