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91.
目的 分析淄博市新发矽肺病患者的分布特点,为政府制定相应的预防措施提供基础依据。方法 整理2005 - 2017年淄博市新发矽肺病报告卡,分析病例特征。结果 新发矽肺病患者629例,其中壹期患者456例,贰期患者83例,叁期患者90例;平均诊断年龄为(50.96±8.63)岁,女性患者诊断年龄(48.53±8.68)岁,低于男性(51.53±8.93)岁,差异具有统计学意义(t = 3.45,P<0.05);接尘工龄中位数M(P25,P75)为15.67(8.29,25.00)年,女性接尘工龄13.58(6.67,20.25)年低于男性17.54(8.42,26.00)年,差异具有统计学意义(Z = - 3.15,P<0.05);男、女矽肺患者从事的工种总体构成不同,但均以粉碎工为主(21.59%和42.85%);行业以耐火材料制品制造业为主,占总体的60.73%,其诊断工龄13.08(7.06,22.79)年和年龄(48.89±6.31)岁,明显低于总体矽肺的诊断工龄15.67(8.29,25.00)年和年龄(50.96±8.63)岁,差异有统计学意义(Z = - 2.582,P<0.05;t = - 4.07,P<0.05)。结论 淄博市矽肺病发病形势严峻,要根据其发病特点,结合当地的产业结构,有重点的制定防控措施。 相似文献
92.
Major histopathological patterns of lung cancer related to arsenic exposure in German uranium miners
Dirk?Taeger Georg?Johnen Thorsten?Wiethege Soile?Tapio Matthias?M?hner Horst?Wesch Andrea?Tannapfel Klaus-Michael?Müller Thomas?Brüning Beate?Pesch 《International archives of occupational and environmental health》2009,82(7):867-875
Objective The mechanisms of action of arsenic in the development of lung cancer are still not yet elucidated. Considering the relationship
between arsenic and squamous cell carcinomas of the skin, we hypothesized that arsenic exposure may be more closely associated
with squamous cell carcinoma of the lung.
Methods A comprehensive histopathological database and a detailed job-exposure matrix developed for former German uranium miners with
exposure to arsenic, radon, and quartz were analyzed to quantitatively assess the effect of arsenic regarding cell type of
lung cancer. The distributions of major lung cancer cell types in 1,786 German uranium miners were associated with levels
of arsenic exposure under control for the other lung carcinogens. To evaluate the arsenic effects in association with a frequent
occupational lung disease in miners stratification by silicosis was performed.
Results There was an arsenic-related increase of the proportion of squamous cell carcinoma of the lung but restricted to miners without
silicosis. The increase was found at all levels of co-exposure to radon and quartz dust. In miners with silicosis, the proportion
of adenocarcinoma increased with rising arsenic exposure. Arsenic exposure was associated with non-small cell lung cancer.
Silicosis turned out as major determinant of the cell type related with arsenic.
Conclusion These results indicate a cell type characteristic effect of arsenic in the development of lung cancer. 相似文献
93.
94.
José Jesús Blanco Pérez Victoria Arnalich Montiel Ángel Salgado-Barreira María Angel Alvarez Moure Adriana Carolina Caldera Díaz Luz Cerdeira Dominguez M. Elena Gonzalez Bello Alberto Fernandez Villar Francisco Javier González Barcala 《Archivos de bronconeumología》2019,55(2):88-92
Objective
To evaluate exercise capacity using the 6-minute walk test (6MWT) in patients with complicated silicosis, and to determine how results shape the prognostic value of 6MWT for hospitalization and mortality.Method
Prospective observational study in 143 patients with complicated silicosis who performed the 6MWT in our outpatient pulmonology clinic between 2009 and the end of 2016. Lung function tests, computed tomography findings and 6MWT parameters (distance walked and oxygen desaturation) were evaluated.Results
Patients with complicated silicosis walked 387 ± 92 m. Results deteriorated as silicosis severity increased; category A: 407 ± 97 m, B: 370 ± 88 m, and C: 357 ± 68 m (P = .022). The 6MWT correlated positively with lung function and inversely with dyspnea determined by mMRC (P < .001). Patients with moderate/severe emphysema and greater CT90 presented a worse result on 6MWT. Patients who walked < 350 m had more hospitalizations (3.7 ± 4.0) than those who walked > 350 m (1.1 ± 2.9). There was an impact on survival: non-survivors walked 327.9 ± 73.0 m, while survivors walked 404.5 ± 89.7 m (P < .001).Conclusions
Spirometry values and category of complicated silicosis correlated with 6MWT and distance walked was a prognostic factor for hospitalization and mortality. The 6MWT is a useful tool in occupational health for monitoring patients with silicosis. 相似文献95.
Genetic polymorphisms in alveolar macrophage response-related genes, and risk of silicosis and pulmonary tuberculosis in Chinese iron miners 总被引:2,自引:0,他引:2
Qu Y Tang Y Cao D Wu F Liu J Lu G Zhang Z Xia Z 《International journal of hygiene and environmental health》2007,210(6):679-689
Alveolar macrophages (AMs) play a prominent role in influencing the development of lung inflammation and injury. The aim of this study is to investigate the roles of AMs response-related genes TNF-alpha, iNOS, and NRAMP1 (SLC11A1) in susceptibility to silicosis and pulmonary tuberculosis (PTB), and to analyze the interaction of dust exposure and genetic susceptibility to silicosis, interactions of TNF-alpha-308 and Natural Resistance-associated Macrophage Protein 1 (NRAMP1) INT4, D543N polymorphisms to PTB. Several epidemiological designs were used: retrospective investigations on dust exposure, case-control studies of 184 silicosis cases and 111 miners occupationally exposed to silica dust, and 1:2 matched case-control studies of 61 PTB cases and 122 PTB-free miners. The miners and controls were recruited from an iron mining operation in Anhui province, China. The polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique was applied to detect single nucleotide polymorphisms. Despite the recruitment of high dust exposure among the controls, silicosis patients still had significantly higher dust exposure than controls (242.6 +/- 98.8 vs. 217.6 +/- 100.7 mg a/m(3)). The mutation of iNOS Ser608Leu is associated with protection against silicosis and against severity of silicosis in the miners. There is a 0.47-fold (95% CI: 0.28-0.79) decrease in risk of silicosis for individuals with C/T, T/T genotype compared with the wild-type homozygous (C/C) individuals after adjustment for occupational exposure, smoking, and drinking. The protection effect of the iNOS polymorphism was particularly detected in the > or = 150 mg a/m(3) exposure group (OR: 0.44, 95% CI: 0.22-0.91). However, no interaction of dust exposure with the iNOS polymorphism was observed. Furthermore, the variant NRAMP1 INT4 genotype is significantly associated with PTB in miners. No association of other polymorphisms (NRAMP1 D543N, TNF-alpha-308) and susceptibility to silicosis or PTB in Chinese miners was found. Our data showed a 3.26-fold (95% CI: 1.47-7.23) increased risk of PTB for miners carrying both the NRAMP1 D543N G/G and NRAMP1 INT4 G/C+C/C genotypes. Additionally, in miners with TNF-alpha-308 G/G genotype, the risk of PTB increased 2.38-fold if they carry the NRAMP1 INT4 G/C+C/C genotype (95% CI: 1.14-4.98). In conclusion, the C>T mutation of iNOS Ser608Leu may be an important protective factor to miners. On the other hand, the variant NRAMP1 INT4 may play a role in the development of PTB in Chinese miners. Therefore, the novel information can be used as guideline for further mechanistic investigations and for strengthening specific protection protocols for workers. 相似文献
96.
目的 矽肺易被误诊,易合并肺结核(pulmonary tuberculosis, PTB),使病情更加复杂。本文探讨矽肺合并活动性肺结核的临床特征。方法 以2018年1月至2021年12月于首都医科大学附属北京胸科医院住院经病原学或病理学确诊的36例矽肺合并活动性肺结核患者为观察组,以同期收治的100例病原学确诊的单纯活动性肺结核患者为对照组,比较分析两组的临床资料。计数资料用百分比表示,组间比较采用χ2检验,非正态分布数据以M(P25,P75)表示。以P<0.05为差异有统计学意义。结果 观察组Ⅰ期矽肺7例(19.4%),Ⅱ期14例(38.9%),Ⅲ期15例(41.7%);结核病程≥12个月25例(69.4%,χ2=17.099),以咳嗽、咳痰、气短为主要症状32例(88.9%,χ2=16.722),胸部CT以结节病灶为主32例(88.9%,χ2=16.722),可见纵膈及肺门淋巴结肿大30例(83.3%,χ2=19.900),曾被误诊17例(47.2%,χ2=7.481),与对照组比较差异有统计学意义(P<0.05);对27例观察组患者进行随访,1例治疗5个月时死亡,17例(65.4%)在治疗2个月内痰液分枝杆菌培养管(mycobacteria growth indicator tube, MGIT)液体培养阴转,5例(19.2%)在2个月至12个月阴转,4例(15.4%)超过12个月才阴转,与对照组比较,差异有统计学意义(P<0.05)。结论 矽肺合并活动性肺结核患者以Ⅱ期和Ⅲ期矽肺为主,结核病程长,以咳嗽、咳痰、气短为主要症状,胸部CT显示肺部病灶以结节为主,多合并纵膈、肺门淋巴结肿大,易被误诊;同时,抗结核疗效差,对矽肺患者进行结核潜伏感染筛查非常必要。 相似文献
97.
98.
Norichika Iga Hideyuki Nishi Nobukazu Fujimoto Takumi Kishimoto 《Respiratory investigation》2018,56(2):144-149
Background
Few studies have focused on the management of secondary spontaneous pneumothorax (SSP) as a complication of pneumoconiosis. The aim of this study was to investigate the clinical features and therapeutic course of SSP associated with silicosis.Methods
Between April 2005 and March 2015, 17 patients with silicosis underwent chest tube drainage for SSP in our institution. We retrospectively analyzed patient characteristics, type of treatment, clinical course, rate of recurrence, and survival time, and compared them with those of 30 patients diagnosed with chronic obstructive pulmonary disease (COPD) during the same period.Results
Fourteen patients with silicosis had performance status score ≥ 2 and modified Medical Research Council Grade ≥ 2; these were significantly different from those in patients with COPD (P = 0.047, P = 0.026). Patients with silicosis had a significantly longer duration of chest tube placement and hospital stay. Recurrent pneumothorax occurred in 47.1% of patients with silicosis, which was not significantly different from the proportion of patients with COPD (40.9%, P = 0.843). However, in the silicosis group, patients treated with chest tube drainage alone tended to have a higher rate of ipsilateral recurrence than those who had pleurodesis, although this was not statistically significant. The median overall survival time of patients with silicosis was 82.6 months, while that of patients with COPD was 104.1 months.Conclusions
Patients with silicosis had worse physical status and respiratory functions at the time of occurrence of pneumothorax than those with COPD. Pleurodesis could be an effective treatment for SSP complicating silicosis. 相似文献99.
Carlos Ramos Martha Montaño Georgina González Felipe Vadillo Moisés Selman 《Lung》1988,166(1):347-353
In spite of several studies, both in vivo and in vitro, the pathogenesis of silicosis remains unclear, mainly in those mechanisms
related to fibrogenesis. In this study, we analyzed the concentration, biosynthesis, and degradation of collagen in silica-treated
rats 7, 15, 30, 45, and 60 days after instillation. Our results showed a significant increase in collagen content and biosynthesis
from the 15th day onward. However, our most remarkable finding was related to collagenolytic activity. In this sense, the
silicotic rats presented a trimodal behavior: some animals showed an increased degradation, others had similar values to those
of the controls, and others exhibited a decrease of collagenolytic activity. Altogether, these results suggest that collagen
deposition in silicotic lungs is due to a rise in biosynthesis and, at least in some animals, to a decrease in degradation.
Neverthless, the steps of collagenolysis must be studied in more detail. 相似文献
100.
目的:了解矽尘暴露者包括硅沉着病患者的结核病患病情况,并分析该人群中结核病发病的危险因素。方法对浙江温岭地区1227例矽尘暴露者进行现场调查,采集基本信息,行胸部 X 线片检查,收集痰标本行结核分枝杆菌培养及鉴定。在单因素分析中,连续变量比较采用两样本 t 检验;分类变量组间两两比较采用χ2检验。多因素分析采用二元 Logistic 回归计算优势比(OR)及95%可信区间(CI )。结果共获得1204例矽尘暴露者完整的基本信息,其中男1201例(99.8%),平均年龄(59.4±6.8)岁。其中硅沉着病0+期(疑似患者)、Ⅰ、Ⅱ、Ⅲ期的患者分别为172例(14.3%)、255例(21.2%)、160例(13.3%)和617例(51.2%)。该人群中结核病患病率约为7300/10万,发病危险因素有硅沉着病Ⅱ期(OR=2.96,95%CI :1.05~8.32,P =0.04)、硅沉着病Ⅲ期(OR =3.88,95%CI :1.58~9.56,P <0.01)、接触结核病患者(OR=4.14,95%CI :1.91~8.98,P <0.01)。硅沉着病合并肺结核患者缺乏特异性症状,发热、体质量减轻较非肺结核患者多见。结论矽尘暴露者包括硅沉着病患者是结核病的高发人群,尤其是硅沉着病Ⅱ期及Ⅲ期、有结核病患者接触史的患者。 相似文献