Kilburn K H, Miller A, Warshaw R H
Environmental Sciences Laboratory, University of Southern California, School of Medicine, Los Angeles 90033.
Respir Med. 1993 Feb;87(2):115-20. doi: 10.1016/0954-6111(93)90138-p.
Total lung capacity was measured in 16 workers with pulmonary asbestosis using four standard methods: body plethysmography, radiographic lung area, helium dilution by multiple breath and by single breath (alveolar volume). All men had irregular opacities of ILO profusion category 2/1 or greater and four had pleural plaques in addition. The radiographic and plethysmographic methods produced virtually identical mean values for TLC of 7.52 l and 7.64 l and for RV of 4.06 l and 4.32 l and all values were larger than those by helium dilution. The closed circuit helium dilution method systematically underestimated TLC with a mean of 5.89 l as did single breath helium dilution with a mean of 6.39 l. These men had a larger mean RV/TLC, measuring 56.9% by body plethysmography and 54.6% by X-ray area than by the rebreathing dilutional method which was 43.8%. Air trapping within a normal TLC which characterizes asbestosis is revealed by radiographic and plethysmographic methods but concealed by gas dilution methods. Use of the latter is at least partly responsible for the impression that asbestosis is a 'restrictive disease'.
采用四种标准方法对16名石棉肺工人的肺总量进行了测量：体容积描记法、胸部X线肺面积测量法、多次呼吸氦稀释法和单次呼吸氦稀释法（肺泡容积）。所有男性的国际劳工组织（ILO）肺野病变密集度均为2/1级或更高，其中4人还伴有胸膜斑。胸部X线测量法和体容积描记法测得的肺总量（TLC）平均值几乎相同，分别为7.52升和7.64升，残气量（RV）分别为4.06升和4.32升，且所有这些值均大于氦稀释法测得的值。闭路氦稀释法系统性地低估了肺总量，平均值为5.89升，单次呼吸氦稀释法的平均值为6.39升。这些人的残气量与肺总量比值（RV/TLC）平均值更大，体容积描记法测得为56.9%，X线面积测量法测得为54.6%，而重复呼吸稀释法测得为43.8%。石棉肺的特征是在正常肺总量范围内存在气体潴留，这可通过胸部X线测量法和体容积描记法显示出来，但气体稀释法会掩盖这一情况。使用后者至少部分导致了石棉肺是一种“限制性疾病”的印象。
