Valkila E H, Nieminen M M, Moilanen A K, Kuusisto P A, Lahdensuo A H, Karvonen J I
Department of Pulmonary Diseases, Tampere University Hospital, Finland.
Am J Ind Med. 1995 Sep;28(3):363-72. doi: 10.1002/ajim.4700280306.
To determine the nature of respiratory functional impairment caused by asbestos-induced visceral pleural fibrosis (VPF) and to discover which pulmonary physiological variable best reveals it, we examined 59 asbestos-exposed construction workers having asbestos-related changes on chest radiographs. Computed tomography scans of the thorax were also performed. Visceral pleural fibrosis was diagnosed in 29 subjects: seven had only VPF, 17 had VPF and pleural plaques, and five had VPF, plaques, and asbestosis. In subjects without VPF, 23 had plaques, six had plaques and asbestosis, and one had only minor fibrotic parenchymal changes insufficient for a diagnosis of asbestosis. Flow-volume spirometry, body plethysmography, static and dynamic compliance, and pulmonary diffusing capacity for carbon monoxide were measured. The subjects with VPF had significantly lower static (p = 0.005) and dynamic (p = 0.007) compliance values than those without. Other respiratory function variables failed to show any significant differences. We conclude that the measurement of static and dynamic compliance is a useful method in assessing pulmonary function impairment caused by visceral pleural fibrosis.
为确定石棉所致脏层胸膜纤维化（VPF）引起的呼吸功能损害的性质，并找出最能揭示该损害的肺生理变量，我们对59名胸部X线片有石棉相关改变的石棉暴露建筑工人进行了检查。还进行了胸部计算机断层扫描。29名受试者被诊断为脏层胸膜纤维化：7名仅有VPF，17名有VPF和胸膜斑，5名有VPF、胸膜斑和石棉肺。在无VPF的受试者中，23名有胸膜斑，6名有胸膜斑和石棉肺，1名仅有轻微的实质性纤维化改变，不足以诊断为石棉肺。测量了流量容积肺活量、体容积描记法、静态和动态顺应性以及一氧化碳肺弥散量。有VPF的受试者的静态（p = 0.005）和动态（p = 0.007）顺应性值显著低于无VPF的受试者。其他呼吸功能变量未显示任何显著差异。我们得出结论，测量静态和动态顺应性是评估脏层胸膜纤维化引起的肺功能损害的一种有用方法。
