职业性尘肺病合并肺结核患者肺通气功能中重度损伤影响因素分析  

Analyzing the influencing factors of moderate-to-severe pulmonary ventilation dysfunction in patients with occupational pneumoconiosis complicated with pulmonary tuberculosis

作　　者：张久红[1] 杨志雄[2] 聂欢 叶绍色[1] ZHANG Jiuhong;YANG Zhixiong;NIE Huan;YE Shaose(不详;Guangxi Zhuang Autonomous Region Center for Occupational Disease Prevention and Control,Nanning,Guangxi 530021,China)

机构地区：[1]广西壮族自治区职业病防治研究院,广西南宁530021 [2]广西壮族自治区人民医院,广西南宁530021

出　　处：《中国职业医学》2024年第4期419-423,共5页China Occupational Medicine

基　　金：广西壮族自治区卫生健康委员会科技研究计划课题(Z20200940)。

摘　　要：目的探讨职业性尘肺病(以下简称“尘肺病”)合并肺结核中重度肺通气功能损伤患者的临床特征与影响因素。方法采用判断抽样方法,选择136例有不同程度肺通气功能损伤的尘肺病合并肺结核男性患者为研究对象,按照其肺通气功能损伤程度分为轻度损伤组和中重度损伤组。收集2组患者的临床资料,分析其肺通气功能损伤的影响因素。结果研究对象中,轻度、中重度肺通气功能损伤患者分别有39.0%和61.0%。随着研究对象尘肺病期别的增加,中重度肺通气功能损伤患者比例也增加(P<0.05)。与轻度损伤组比较,中重度损伤组患者气促、C反应蛋白升高、合并慢性阻塞性肺疾病(COPD)和近2年肺部感染史检出率均增高(P值均<0.05)。多因素logistic回归分析结果显示,尘肺病期别、合并COPD和近2年肺部感染史均是中重度肺通气功能损伤的危险因素(P值均<0.05)。其中,尘肺病期别越高者出现中重度肺通气功能损伤的风险越高;合并COPD、近2年有肺部感染史者出现中重度肺通气功能损伤的概率更高。结论尘肺病期別、合并COPD和近2年肺部感染史是导致尘肺病合并肺结核患者出现肺通气功能中重度损伤的影响因素;应及时诊断尘肺病的晋期,早期发现COPD和肺部感染,并相应给予规范治疗。Objective To investigate the clinical characteristics and influencing factors of moderate-to-severe pulmonary ventilation dysfunction in occupational pneumoconiosis(hereinafter referred to as"pneumoconiosis")patients complicated with pulmonary tuberculosis.Methods A total of 136 male pneumoconiosis patients complicated with pulmonary tuberculosis suffering different degrees of pulmonary ventilation dysfunction were selected as the study subjects using the judgmental sampling method.Patients were divided into mild dysfunction and moderate-to-severe dysfunction groups based on the degrees of pulmonary ventilation dysfunction.Clinical data from patients of these two groups were collected,and influencing factors of pulmonary ventilation dysfunction were analyzed.Results The prevalence of mild dysfunction and moderate-to-severe dysfunction among the study subjects was 39.0%and 61.0%,respectively.The proportion of patients with moderate-to-severe pulmonary ventilation dysfunction increased with the progression of pneumoconiosis(P<0.05).Patients in moderate-to-severe dysfunction group had higher rates of dyspnea,elevated C-reactive protein,coexisting chronic obstructive pulmonary disease(COPD),and a history of lung infections within the past two years compared with those in the mild dysfunction group(all P<0.05).The result of multivariate logistic regression analysis showed that the degree of pneumoconiosis,complicated with COPD,and a history of lung infections within the past two years were risk factors for moderate-to-severe pulmonary ventilation dysfunction(all P<0.05).Specifically,higher degree of pneumoconiosis was associated with a greater proportion of moderate-to-severe dysfunction,and patients complicated with COPD or had a history of lung infections within the past two years were more likely to experience severe pulmonary ventilation dysfunction.Conclusion The degree of pneumoconiosis,complicated with COPD,and a history of lung infections within the past two years are influencing factors of moderate-to-severe

关 键 词：尘肺病 肺结核 肺功能 肺部感染 影响因素 

分 类 号：R135.2[医药卫生—劳动卫生]