煤工尘肺与矽肺患者肺功能损伤情况及其相关影响因素

目的探析煤工尘肺与矽肺患者肺功能的损伤情况,总结相关影响因素,为临床预防及研究提供参考。方法选取2013年5月-2016年5月该院收治的煤工尘肺与矽肺确诊病例共180例,按照疾病类型分为煤工尘肺组(112例)与矽肺组(68例),选取同期可疑尘肺病患者80例为对照组.。对符合纳入标准的患者统一予以X射线胸片检查、肺功能检测,分析煤工尘肺与矽肺不同期别(壹期、贰期、叁期)小阴影分布肺区情况、阴影的类型、尘肺小阴影密集度等。同时进行χ2检验、独立样本t检验分析以及Spearman相关性分析。结果煤工尘肺和矽肺的期别越高,患者的肺功能异常情况越严重;煤工尘肺和矽肺各期别之间差异有统计学意义(P<0.05);煤工尘肺和矽肺小阴影分布肺区、X射线胸片检查小阴影密集度与患者肺功能异常率呈明显正相关性(r=0.945、0.987);煤工尘肺、矽肺有小阴影及大阴影聚集者较单纯小阴影患者肺功能的异常率高(P<0.05);随着患者工龄的增加、肺功能异常情况也随之严重,但组间差异无统计学意义(P>0.05);吸烟组、戒烟组与不吸烟组比较,肺功能异常率较高(P<0.05)。结论煤工尘肺病期别高,则肺功能异常率也相应升高;煤工尘肺病和矽肺患者的小阴影分布肺区、密集度与肺功能异常率呈现明显正相关;小阴影与大阴影聚集患者较单纯小阴影患者对肺功能的影响更大;吸烟和戒烟者的肺功能异常率要高于不吸烟者。

On lung function of patients with coal workers' pneumoconiosis or silicosis and related influencing factors

Objective To investigate the lung function in patients with coal worker’s pneumoconiosis and silicosis,and analyze the related influencing factors,so as to provide evidence for clinical prevention and research.Methods A total of 180 confirmed cases of coal worker’s pneumoconiosis and silicosis admitted to a hospital from May 2013 to May 2016 were selected.According to the disease types they were divided into coal workers pneumoconiosis group(112 cases)and silicosis group(68 cases).At the same time,80 cases of suspected pneumoconiosis were selected as control group.All of the subjects were complied with the unified standardized methods of X-ray chest examination,pulmonary function testing,and examinations of small shadow distribution in lung areas,the type of shadow,and pneumoconiosis small shadow density at different stages(Ⅰ,Ⅱ,Ⅲ)of coal workers pneumoconiosis and silicosis.Chi-square(2)test,independent sample t test and Spearman correlation analysis were conducted.Results The higher the stage of coal worker’s pneumoconiosis and silicosis,the more serious the abnormal lung function was.The difference between coal worker’s pneumoconiosis and silicosis was statistically significant(P<0.05).The small shadow distribution of coal worker’s pneumoconiosis and silicosis showed a significant positive correlation between the small shadow density and the abnormal rate of lung function(r=0.945,0.987).The abnormal rate of lung function was higher in the patients with small shadow and large shadow accumulation in coal worker’s pneumoconiosis and silicosis than in patients with simple small shadow(P<0.05).As the working years of the patients increased,the pulmonary dysfunction was also serious,but the difference between the groups was not statistically significant(P>0.05);The rate of pulmonary dysfunction was higher in the smoking group,and statistical significance was found between the smoking group and the non-smoking group(P<0.05).Conclusions With the higher state of the coal worker pneumoconiosis,lung function abnormality rate also increases correspondingly.There is a significant positive correlation between small shadow distribution in lung areas and shadow density with abnormal rate of lung function in patients with coal worker pneumoconiosis and silicosis.The effects of small shadow and large shadow on lung function are greater than that in patients with simple small shadow.Current smokers and smoking-quitters had higher rates of pulmonary dysfunction than nonsmokers.