煤工尘肺与矽肺患者肺功能损伤情况及其相关影响因素
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摘要
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。
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.
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.
引文
[1]秦克江,叶绍色,王力珩.尘肺病初诊患者进入尘肺病正式诊断复诊阶段的情况及其影响因素[J].广西医学,2017,39(10):1486-1488.
[2]白璐,杜红,王如刚.北京市近年职业病诊断与鉴定工作情况[J].中华劳动卫生职业病杂志,2015,33(8):624-626.
[3]崔风涛,丁新平,许洁,等.某矿业集团347例尘肺并发肺结核死亡病例分析[J].中华劳动卫生职业病杂志,2013,31(11):853-854.
[4]周昌盛,张霖,陈学秀,等.矽肺患者结核易感相关基因的多态性分析[J].中国地方病防治杂志,2015,30(1):17.
[5]Nho RS,Hergert P.IPF fibroblasts are desensitized to typeⅠcollagen matrix-induced cell death by suppressing lowautoph-agy via aberrant Akt/mTORkinases[J].PLoS ONE,2014,9(4):e94616.
[6]Pupyshev AB.Reparative autophagy and autophagy death of cells.Functional and regulatory aspects[J].Tsitologiia,2014,56(3):179.
[7]李大权,陈丹,翟日洪.纤维支气管镜介入在矽肺合并肺结核治疗中的应用效果分析[J].中国医药指南,2014,12(14):80.
[8]Singh KK,Lovren F,Pan Y,et al.The essential autophagy gene ATG7 modulates organ fibrosis via regulation of endothelial-tomesenchymal transition[J].J Biol Chem,2015,290(5):2547.
[9]邱新香,谭丽珍,曾伟芳,等.尘肺病174例患者生活质量调查[J].职业与健康,2014,30(8):1040-1043.
[10]邱新香,陈慈珊,温绿琴,等.尘肺病患者社会人口学特征对生活质量影响研究[J].中国职业医学,2013,40(1):10-1.
[11]李冬红,刘健,陈志军,等.临床护理路径在尘肺患者健康教育中的应用[J].中国临床新医学,2015,8(10):979-982.
[12]刘英姿,王凤玲,王东升,等.沙美特罗/丙酸氟替卡松联合缩唇呼吸治疗尘肺病合并慢性阻塞性肺疾病效果研究[J].中国职业医学,2016,43(2):148-151.
[13]秦克江,叶绍色,王力珩,等.广西市级尘肺病诊断机构诊断质量调查研究[J].中国煤炭工业医学杂志,2014,17(8):1324-1326.
[14]秦克江,叶绍色,王力珩,等.广西省粉尘作业者职业健康检查尘肺病漏诊分析[J].环境与职业医学,2015,32(4):347-350.
[15]马建伟.236例煤工尘肺患者肺通气功能测定结果分析[J].继续医学教育,2015,29(12):67-68.
[2]白璐,杜红,王如刚.北京市近年职业病诊断与鉴定工作情况[J].中华劳动卫生职业病杂志,2015,33(8):624-626.
[3]崔风涛,丁新平,许洁,等.某矿业集团347例尘肺并发肺结核死亡病例分析[J].中华劳动卫生职业病杂志,2013,31(11):853-854.
[4]周昌盛,张霖,陈学秀,等.矽肺患者结核易感相关基因的多态性分析[J].中国地方病防治杂志,2015,30(1):17.
[5]Nho RS,Hergert P.IPF fibroblasts are desensitized to typeⅠcollagen matrix-induced cell death by suppressing lowautoph-agy via aberrant Akt/mTORkinases[J].PLoS ONE,2014,9(4):e94616.
[6]Pupyshev AB.Reparative autophagy and autophagy death of cells.Functional and regulatory aspects[J].Tsitologiia,2014,56(3):179.
[7]李大权,陈丹,翟日洪.纤维支气管镜介入在矽肺合并肺结核治疗中的应用效果分析[J].中国医药指南,2014,12(14):80.
[8]Singh KK,Lovren F,Pan Y,et al.The essential autophagy gene ATG7 modulates organ fibrosis via regulation of endothelial-tomesenchymal transition[J].J Biol Chem,2015,290(5):2547.
[9]邱新香,谭丽珍,曾伟芳,等.尘肺病174例患者生活质量调查[J].职业与健康,2014,30(8):1040-1043.
[10]邱新香,陈慈珊,温绿琴,等.尘肺病患者社会人口学特征对生活质量影响研究[J].中国职业医学,2013,40(1):10-1.
[11]李冬红,刘健,陈志军,等.临床护理路径在尘肺患者健康教育中的应用[J].中国临床新医学,2015,8(10):979-982.
[12]刘英姿,王凤玲,王东升,等.沙美特罗/丙酸氟替卡松联合缩唇呼吸治疗尘肺病合并慢性阻塞性肺疾病效果研究[J].中国职业医学,2016,43(2):148-151.
[13]秦克江,叶绍色,王力珩,等.广西市级尘肺病诊断机构诊断质量调查研究[J].中国煤炭工业医学杂志,2014,17(8):1324-1326.
[14]秦克江,叶绍色,王力珩,等.广西省粉尘作业者职业健康检查尘肺病漏诊分析[J].环境与职业医学,2015,32(4):347-350.
[15]马建伟.236例煤工尘肺患者肺通气功能测定结果分析[J].继续医学教育,2015,29(12):67-68.
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