金属(锌)粉尘肺沉着病4例患者脱离粉尘作业后的动态影像学观察  

Dynamic imaging observation of 4 cases of metal(zinc)dust pulmonary disease after divorcing from dust exposure

作　　者：孙治平 赵德发 李宝平 王新 高丽妮 林璐 侯博文 张晓雨 

机构地区：[1]煤炭总医院职业病科,北京100028 [2]贵阳市职业病防治院职业病诊疗中心,贵州贵阳550004

出　　处：《职业与健康》2016年第19期2709-2711,共3页Occupation and Health

基　　金：公益性行业科研专项经费(201402021)

摘　　要：目的了解金属粉尘（锌）肺沉着病患者脱离粉尘作业后的动态影像学变化特征,为金属粉尘（锌）肺沉着病的诊断提供参考依据。方法对1998年就诊于某职业病防治院的4例金属粉尘（锌）肺沉着病患者脱离金属粉尘作业后连续12~18 a的影像学改变进行动态观察,组织5名资深专家对患者的初诊及随访X线胸片进行集体阅片,参考尘肺病诊断标准及标准片,记录小阴影的形态、总体密集度、小阴影分布肺区、尘肺期别,将专家的阅片意见汇总后整理数据。结果该组病例的X线胸片最初诊断均达到尘肺壹期改变,影像学表现以全肺弥漫分布的高密度的圆形小阴影为主,随着脱离粉尘时间的延长,4例患者8个肺区的圆形小阴影数量减少,3例患者已达不到尘肺壹期改变。结论金属粉尘（锌）肺沉着病患者脱尘后,在一定时间内,肺部X线阴影可出现部分自行消退现象。[Objective]To understand the dynamic imaging change characteristics of patients with metal（zinc） dust pulmonary disease after divorcing from dust exposure,provide the reference for diagnosis of metal（zinc） dust pulmonary disease.[Methods] 4 patients with metal（zinc） dust pulmonary disease,who were treated in a occupational disease prevention hospital in 1998,were enrolled in the study,to observe the dynamic imaging changes during 12-18 years after they divorced from dust exposure. The data of first diagnosis and follow-up X-ray radiograph were analyzed by five senior experts. According to pneumoconiosis diagnosis criteria and standards,the small shadow form,overall intensity,small lung shadow distribution area and stage of pneumoconiosis were recorded. And the opinions of experts were summed and analyzed. [Results]The initial diagnosis of X-ray radiograph in all cases reached the stage Ⅰ of pneumoconiosis,and the imaging performance was mainly high-density small circular shadows in the diffuse distribution. With the extension of divorcing from dust exposure,the number of small circular shadows decreased in 8 lung areas of 4 patients,and 3 patients did not reach the stage Ⅰof pneumoconiosis.[Conclusion]The chest X-ray shadows may regress spontaneously after a period of divorcing from dust exposure in patients with metal（zinc） dust pulmonary disease.

关 键 词：金属粉尘肺沉着病 圆形小阴影 自净作用 

分 类 号：R135.2[医药卫生—劳动卫生]