Li X, Dai W R, Liu W F, Yang Z X, Xie L, Wu Z Y
Hunan Occupational Disease Prevention and Control Hospital, Changsha 410007, China.
Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2020 Dec 20;38(12):891-894. doi: 10.3760/cma.j.cn121094-20200212-00055.
To investigate the characteristics of pulmonary function changes and its possible influencing factors in patients with pneumoconiosis. In December 2019, pneumoconiosis patients hospitalized in four departments of occupational diseases in Hunan Occupational Disease Prevention and Control Hospital from December 2015 to December 2016 were selected as subjects. Lung function including forced vital capacity (FVC) , FVC%, forced expiratory volume in one second (FEV1) , FEV1%, forced expiratory volume in one second / forced vital capacity (FEV1/FVC) , diffusion capacity of the lung foe carbon monoxide% (DLCO%) 、maximal expiratory rlow 75% (MEF75%) , maximal expiratory rlow 50% (MEF50%) and maximal expiratory rlow 25% (MEF25%) were tested, and collect their age, occupation history, smoking history and Chronic Obstructive Pulmonary Disease Self Rating Questionnaire (CAT) score. They were followed up after 3 years to analyze the 3-year decline rates of lung function indicators and their relationship with stage of pneumoconiosis, age, smoking index, baseline values of lung function and CAT score. 265 cases were studied effectively. After 3 years, the values of 9 lung function indicators of pneumoconiosis patients were significantly lower than those of 3 years ago (<0.05) . The decline rates of FEV1%, FEV1/FVC, MEF75%, MEF50% and MEF25% were positively correlated with the stage of pneumoconiosis (=0.250, 0.290, 0.219, 0.280, 0.141, <0.05) . The decline rates of FEV1% and MEF75% were positively correlated with smoking index (=0.148, 0.152, <0.05) . The decline rates of DLCO% and MEF25% were positively correlated with the baseline value of initial pulmonary function (=0.276, 0.153, <0.05) , while the decline rates of FEV1%, FEV1/FVC and MEF50% were negatively correlated with the baseline values of initial pulmonary function (=-0.215, -0.146, -0.214, <0.05) . The decline rates of FVC%, FEV1%, MEF75% and MEF50% were positively correlated with the changes of CAT scores (=0.147, 0.208, 0.210, 0.196, <0.05) . Logistic regression analysis showed that old age and high initial value of DLCO% were the risk factor for the decline of DLCO% (=1.105、1.078, <0.05) .High smoking index was the risk factors for the decline of MEF75% (=1.016, <0.05) . High stage and the increase of CAT score were the risk factors for the decline of MEF50% (=1.548, 1.162, <0.05) . High initial value of MEF25% was the risk factor for the decline of MEF25% (=1.010, <0.05) . The pulmonary function index of pneumoconiosis patients declined significantly in 3 years. The stage of pneumoconiosis, age, smoking index and degree of pulmonary function damage were related to the decline rate of pulmonary function.
探讨尘肺病患者肺功能变化特点及其可能的影响因素。选取2015年12月至2016年12月在湖南省职业病防治院4个职业病科住院的尘肺病患者为研究对象。检测其肺功能,包括用力肺活量(FVC)、FVC%、一秒用力呼气容积(FEV1)、FEV1%、一秒用力呼气容积/用力肺活量(FEV1/FVC)、肺一氧化碳弥散量%(DLCO%)、最大呼气流量75%(MEF75%)、最大呼气流量50%(MEF50%)和最大呼气流量25%(MEF25%),并收集其年龄、职业史、吸烟史及慢性阻塞性肺疾病自我评估问卷(CAT)评分。随访3年后,分析肺功能指标的3年下降率及其与尘肺病分期、年龄、吸烟指数、肺功能基线值和CAT评分的关系。共纳入有效研究对象265例。3年后,尘肺病患者9项肺功能指标值均显著低于3年前(<0.05)。FEV1%、FEV1/FVC、MEF75%、MEF50%和MEF25%的下降率与尘肺病分期呈正相关(=0.250、0.290、0.219、0.280、0.141,<0.05)。FEV1%和MEF75%的下降率与吸烟指数呈正相关(=0.148、0.152,<0.05)。DLCO%和MEF25%的下降率与初始肺功能基线值呈正相关(=0.276、0.153,<0.05),而FEV1%、FEV1/FVC和MEF50%的下降率与初始肺功能基线值呈负相关(=-0.215、-0.146、-0.214,<0.05)。FVC%、FEV1%、MEF75%和MEF50%的下降率与CAT评分变化呈正相关(=0.147、0.208、0.210、0.196,<0.05)。Logistic回归分析显示,高龄和较高的初始DLCO%值是DLCO%下降的危险因素(=1.105、1.078,<0.05)。高吸烟指数是MEF75%下降的危险因素(=1.016,<0.05)。高分期和CAT评分升高是MEF50%下降的危险因素(=1.548、1.162,<0.05)。较高的初始MEF25%值是MEF25%下降的危险因素(=1.010,<0.05)。尘肺病患者肺功能指标在3年内显著下降。尘肺病分期、年龄、吸烟指数及肺功能损害程度与肺功能下降率有关。