Jones R N, McLoud T, Rockoff S D
Pulmonary Disease Section, Tulane University School of Medicine, New Orleans, Louisiana.
J Thorac Imaging. 1988 Oct;3(4):57-66. doi: 10.1097/00005382-198810000-00009.
The effects of asbestos-induced benign pleural conditions on pulmonary function have been controversial since this subject was first studied in the mid-1960s. Firm conclusions have been difficult to reach because of (1) the difficulty of taking into account asbestos exposure, which may have effects on pulmonary function other than those mediated through pleural lesions, (2) the disagreement over the type and extent of radiographic pleural abnormalities, (3) the imprecision in measuring pulmonary function, and (4) the numerous potential confounding factors of reduced pulmonary function, such as cigarette smoking, age, concurrent occupational exposures, and prior chest diseases or trauma. This article critically evaluates the published reports on the functional significance of asbestos-induced pleural conditions. The results of this analysis lead to the conclusion that (1) pleural plaques are not associated with clinically significant reductions in pulmonary function, (2) diffuse pleural thickening, when extensive, can severely impair ventilation, and (3) restriction with a preserved diffusing capacity is the expected pattern when pleural lesions are responsible for reduced pulmonary function.
自20世纪60年代中期首次对该主题进行研究以来，石棉引起的良性胸膜疾病对肺功能的影响一直存在争议。由于以下原因，很难得出确凿的结论：（1）难以考虑石棉暴露情况，石棉暴露可能对肺功能产生除通过胸膜病变介导之外的其他影响；（2）对于放射影像学胸膜异常的类型和程度存在分歧；（3）肺功能测量不够精确；（4）肺功能降低存在众多潜在混杂因素，如吸烟、年龄、同时存在的职业暴露以及既往胸部疾病或创伤。本文对已发表的关于石棉引起的胸膜疾病功能意义的报告进行了批判性评估。该分析结果得出以下结论：（1）胸膜斑与临床上显著的肺功能降低无关；（2）广泛的弥漫性胸膜增厚可严重损害通气功能；（3）当胸膜病变导致肺功能降低时，预期的模式是伴有保留的弥散能力的限制性通气障碍。
