Susskind H, Acevedo J C, Iwai J, Rasmussen D L, Heydinger D K, Pate H R, Harold W H, Brill A B
Medical Research Center, Brookhaven National Laboratory, Upton, New York 11973.
Eur Respir J. 1988 Mar;1(3):232-41.
Twenty life-long nonsmoking West Virginia coal-miners participated in a study to amplify the role of focal irregularities on regional ventilation (V) and perfusion (Q) and to develop an improved method for the early detection of coal-workers' pneumoconiosis. Their mean age was 59.3 yr and they averaged 35.2 years' exposure to coal dust. Conventional pulmonary function tests were supplemented by measurement of V, Q and lung volume (V), using radioactive Kr-81m, Tc-99m MAA and Xe-127, respectively, to determine regional abnormalities in lung function. A computer analysis of the regional distributions of V/V, Q/V and V/Q was performed, and their topographical distributions and indices of heterogeneity (HI) computed. V/V and Q/V were significantly reduced in the lower third, and increased in the upper two-thirds of the miners' lungs; V/Q was reduced in the upper half. The miners' V/V and Q/V were more heterogeneous (p less than 0.001) than that of eleven age-matched controls, with mean ventilation HI values of 0.190 +/- 0.027 and 0.133 +/- 0.011, respectively, and mean perfusion HI values of 0.206 +/- 0.022 and 0.164 +/- 0.041, respectively. P(A-a)O2 correlated positively (r = 0.72; p less than 0.001) with ventilation HI. Gas exchange was the most significant functional measurement, being abnormal in 19/20 subjects. In contrast, conventional spirometric measurements were within the predicted normal limits in all but four miners.
20名终身不吸烟的西弗吉尼亚州煤矿工人参与了一项研究，以扩大局灶性异常对区域通气（V）和灌注（Q）的作用，并开发一种改进的方法用于早期检测煤工尘肺。他们的平均年龄为59.3岁，平均接触煤尘35.2年。常规肺功能测试通过分别使用放射性氪-81m、锝-99m标记的大聚合白蛋白和氙-127测量V、Q和肺容积（V）来补充，以确定肺功能的区域异常。对V/V、Q/V和V/Q的区域分布进行了计算机分析，并计算了它们的地形分布和异质性指数（HI）。V/V和Q/V在矿工肺部的下三分之一显著降低，在上三分之二升高；V/Q在上半部分降低。矿工的V/V和Q/V比11名年龄匹配的对照组更具异质性（p<0.001），平均通气HI值分别为0.190±0.027和0.133±0.011，平均灌注HI值分别为0.206±0.022和0.164±0.041。肺泡-动脉血氧分压差（P(A-a)O2）与通气HI呈正相关（r = 0.72；p<0.001）。气体交换是最显著的功能测量指标，20名受试者中有19名异常。相比之下，除4名矿工外，所有矿工的常规肺量计测量值均在预测的正常范围内。
