石棉肺的肺功能分析  

Study on pulmonɑry function of asbestosis

作　　者：胡振华[1] 王绵珍[2] 王治明[2] 兰亚佳[2] 

机构地区：[1]上海市卫生局卫生监督所,上海200050 [2]四川大学公共卫生学院劳动卫生教研室,四川成都610041

出　　处：《中国工业医学杂志》2006年第5期257-259,共3页Chinese Journal of Industrial Medicine

摘　　要：目的探讨石棉肺的肺功能改变特点。方法以某温石棉厂134名男性工人为接触组,同一地区不接触粉尘,且劳动强度与接触组大体相似的某仪表厂135名男性工人为对照组,对其肺功能测定和胸部X线检查结果进行对比分析。结果协方差分析结果显示,在控制了累积吸烟量等混杂因素的影响后,与对照组相比,无石棉肺组FVC和FEV1显著下降,Ⅰ期石棉肺组FVC、FEV1和FEV1/FVC%显著下降、Kco显著升高,Ⅱ期石棉肺组FVC、FEV1和FEV1/FVC%显著下降(P<0·05);而与无石棉肺组相比,Ⅰ期石棉肺组FVC显著下降、Kco显著升高,Ⅱ期石棉肺组FVC、FEV1和FEV1/FVC%显著下降(P<0·05)。偏相关分析结果显示,在控制了接尘年限和累积吸烟量等混杂因素的影响后,石棉肺期别与FVC、FEV1和FEV1/FVC%呈显著负相关,与Kco呈显著正相关(P<0·05);与DLco呈负相关,但差别无统计学意义(P>0·05)。结论早期石棉肺主要表现为限制性肺通气功能障碍,随着石棉肺进一步发展,除肺限制性损害程度加重外,亦呈现阻塞性肺功能损害。Objective To investigate the features of pulmonary functional changes in asbestos workers. Method 134 male asbestos workers were selected as the exposure group, and 135 asbestos-unexposed male workers in the same working region were selected as the controls. All the investigated objects were given pulmonary function test and posteroanterior chest radiography examination. Result The covariance analysis revealed, after controlling for the confounding variables such as pack-year of smoking etc., the asbestos workers showed significantly reduced FVC and FEV1 compared with controls despite without asbestosis; those with category I of asbestosis showed some reduce of FEV1/FVC% and rise of Kco except the decrease of FVC and FEV1, those with category H of asbestosis showed obvious reduce of FVC, FEV1 and FEV1/FVC% （ P 〈 0.05）. The partial correlation analysis revealed, after controlling the confounding variables such as pack-year of smoking, duration of asbestos exposure etc., the category of asbestosis showed negative correlation with FVC, FEV1, FEV1/FVC% and positive correlation with Kco （P 〈 0.05）. Conclusion The earlier change of pulmonary function in asbestos workers should be the restrictive dysfunction of pulmonary ventilation, it could aggravate gradually with the development of asbestosis and even might complicate with obstructive dysfunction of pulmonary ventilation.

关 键 词：石棉工人 石棉肺 肺功能 X射线分期 

分 类 号：R135.2[医药卫生—劳动卫生]