肺功能与血气分析在尘肺病患者劳动能力鉴定中的意义

目的 通过分析尘肺病患者肺功能与血气分析的分布特征，筛选最敏感的检测指标，为劳动能力鉴定提供参考。方法 采用秩和检验及χ2检验比较分析进行劳动能力鉴定的373例尘肺病患者肺功能与血气分析检测指标在不同尘肺期别、尘肺类型、工种、接尘工龄段以及不同组间肺功能及血气分析检测异常率的分布特征，肺功能指标包括FVC、FEV1、FEV1/FVC、MVV、RV/TLC、DLco，血气分析指标包括PaO2、PaCO2、pH。结果 不同尘肺期别中，FEV1/FVC(H = 4.338)、RV/TLC(H = 13.616)、PaO2(H = 4.071)、PaCO2(H = 8.680)及肺功能(χ2 = 12.205)、血气分析(χ2 = 5.737)检测异常率差异有统计学意义(P＜0.05)；不同尘肺类型中，PaCO2(H = 8.768)差异有统计学意义(P＜0.05)；不同工种间各检测值差异无统计学意义(P＞0.05)；不同接尘工龄段间FEV1(H = 7.931)、FEV1/FVC(H = 9.060)和肺功能检测异常率(χ2 = 14.712)差异有统计学意义(P＜0.05)。结论 肺功能中FEV1、FEV1/FVC、RV/TLC，血气分析中PaO2为最敏感的指标，鉴定中可主要参考以上指标，做出更准确的判断。

Significance of pulmonary function and blood gas analysis in the identification of labor ability of patients with pneumoconiosis

Abstract: Objective By analyzing the distribution characteristics of pulmonary function and blood gas analysis in pneumoconiosis patients, the most sensitive detection indexes were found out, which provided reference for the identification of labor ability of pneumoconiosis patients. Methods Rank sum test and chi-square test were used to compare and analyze the distribution characteristics of lung function and blood gas analysis indicators and its abnormal rates of 373pneumoconiosis patients performing labor ability identification in different stages of pneumoconiosis, pneumoconiosis type, work type, dusting period. Pulmonary function indicators included FVC, FEV1, FEV1/FVC, MVV, RV/TLC, DLco, blood gas analysis indicators included PaO2, PaCO2, pH. Results In different stages of pneumoconiosis, there were statistically significant differences in abnormal rates detected by FEV1/FVC (H=4.338), RV/TLC (H=13.616), PaO2 (H=4.071), PaCO2 (H=8.680), lung function (χ2=12.205) and blood gas analysis (χ2=5.737) (P<0.05). Among different pneumoconiosis types, there was a statistically significant difference in PaCO2 (H =8.768)(P<0.05). There was no significant difference in the detection index between different types of work (P>0.05). There were statistically significant differences in FEV1 (H=7.931), FEV1/FVC (H=9.060) and abnormal pulmonary function test (χ2=14.712) between different dusting period (P<0.05). Conclusion FEV1, FEV1/FVC, RV/TLC in lung function and PaO2 in blood gas analysis are the most sensitive index, which can be referred to in the judgment of the labor ability identification results of pneumoconiosis patients to make it more accurate.