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煤矿工人尘肺:阴影密集度与尘肺病变数量及类型之间的相关性,特别提及阴影类型

Coalworkers' pneumoconiosis: correlation between opacity profusion and number and type of dust lesions with special reference to opacity type.

作者信息

Fernie J M, Ruckley V A

出版信息

Br J Ind Med. 1987 Apr;44(4):273-7. doi: 10.1136/oem.44.4.273.

Abstract

The relation between the profusion and predominant type of small rounded opacities on chest radiographs taken within four years of death and the postmortem counts of dust lesions in four classes (macules, "pinhead" fibrotic nodules, nodules 1-3 mm, and nodules greater than 3-9 mm in diameter) has been examined for 71 coalworkers without progressive massive fibrosis. The radiographs were categorised by four readers independently, according to the ILO classification. For subjects considered by each reader to present predominantly p type opacities, increasing opacity profusion was exclusively and significantly associated with an increase in the number of pinhead fibrotic nodules. Numbers of nodules measuring 1-3 mm and greater than 3-9 mm in diameter both showed significant linear associations with opacity profusion category in subjects presenting predominantly q opacities, the closer association being observed with the smaller lesions. These observations held true for all readers. Opacities of type r were rarely considered to be the predominant type. For the reader who recorded the maximum number of such cases, opacity profusion was not significantly related to the numbers of dust lesions in any of the lesion classes. Nevertheless, the closest association was observed with nodules measuring greater than 3-9 mm in diameter. An overall significant linear association between total lung dust content and opacity profusion was found to be due mainly to subjects presenting predominantly p type opacities and to a lesser extent to those with predominantly q opacities.

摘要

对71名无进行性大块纤维化的煤矿工人进行了研究,分析其死亡前四年内胸部X光片上小圆形阴影的密集度和主要类型与死后四类粉尘病变(斑点、“针头”样纤维化结节、直径1 - 3毫米的结节以及直径大于3 - 9毫米的结节)数量之间的关系。四位阅片者根据国际劳工组织(ILO)分类标准对X光片进行独立分类。对于每位阅片者认为主要呈现p型阴影的受试者,阴影密集度增加仅与“针头”样纤维化结节数量增加显著相关。对于主要呈现q型阴影的受试者,直径1 - 3毫米和大于3 - 9毫米的结节数量均与阴影密集度类别呈现显著线性关系,与较小病变的相关性更紧密。所有阅片者的观察结果均如此。r型阴影很少被认为是主要类型。对于记录此类病例数量最多的阅片者,阴影密集度与任何一类病变中的粉尘病变数量均无显著相关性。然而,与直径大于3 - 9毫米的结节相关性最为紧密。发现肺总粉尘含量与阴影密集度之间总体存在显著线性关系,这主要归因于主要呈现p型阴影的受试者,在较小程度上也归因于主要呈现q型阴影的受试者。

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