尘肺病患者肺功能与血气分析相关性研究
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摘要
目的了解淄博市尘肺病患者肺功能与血气分析的基本情况,探讨两者之间的相关性。方法对141例尘肺病患者进行肺功能和血气分析检查,分析两者同尘肺病期别、工龄、年龄的关系,以及肺功能受损程度与血气分析的关系。结果随着尘肺病期别的提高,肺功能第1秒用力呼气量(FEV1)、1秒率(FEV1%)、呼气峰流速值(PEF)、一氧化碳弥散量(DLCO)和血气分析动脉血氧分压(PaO_2)各指标有下降趋势(r=-0.395、-0.373、-0.398、-0.373、-0.203,均P<0.05)。随着年龄增长,肺功能FEV1、PEF和血气分析PaO_2各指标呈下降趋势(r=-0.208、-0.194、-0.219,均P<0.05),肺泡与动脉毛细血和血氧分压差[P(A-a)O_2]指标呈上升趋势(r=0.186,P<0.05)。肺功能和血气分析指标与工龄无关。血气分析指标PaO_2与肺功能指标FEV1、FEV1%、PEF、DLCO呈正相关(r=0.312、0.217、0.200、0.232,均P<0.05),P(A-a)O_2与肺功能指标FEV1、FEV1%、PEF、DLCO呈负相关(r=-0.297、-0.167、-0.179、-0.246,均P<0.05)。肺功能损伤程度与血气分析指标PaO_2呈负相关(r=-0.360,P<0.01)。结论通过对尘肺病患者肺功能和血气分析相关性的研究,本研究认为尘肺病期别及年龄均可影响肺功能和血气分析,与患者的接尘工龄无关。尘肺病患者肺功能的损伤与血气分析的情况一致。
[Objective] To investigate the relationship between pulmonary function and blood gas in patients with pneumoconiosis in Zibo City. [Methods ] The pulmonary function and blood gas test were performed in 141 patients with pneumoconiosis, to analyze the relationship between them and the stage of pneumoconiosis, length of service, age. The degree of lung function damage and blood gas analysis was analyzed.[Results] As the stage of pneumoconiosis increased, the pulmonary function indexes of forced expiratory volume in the first second(FEV1), the ratio of FEV1(FEV1%), peak expiratory flow(PEF), carbon monoxide diffusion capacity(DLCO) and blood gas analysis index of arterial partial pressure of oxygen(PaO_2) showed a tendency to decrease(r=-0.395,-0.373,-0.398,-0.373,-0.203, all P<0.05). With the increase of age, the pulmonary function indexes of FEV1 and PEF blood gas analysis index of PaO_2 showed a decreasing trend(r=-0.208,-0.194,-0.219, all P<0.05), and the alveolar and arterial capillary blood and oxygen partial pressure difference[P(A-a)O_2] showed an increasing trend(r=0.186, P<0.05). The indexes of pulmonary function and blood gas analysis were not related to length of service. The blood gas analysis index of PaO_2 was positively correlated with the pulmonary function indexes of FEV1, FEV1%, PEF and DLCO(r=0.312, 0.217, 0.200, 0.232, all P <0.05), while P(A-a)O_2 was negatively correlated with the pulmonary function indexes of FEV1, FEV1%, PEF and DLCO(r=-0.297,-0.167,-0.179,-0.246, all P<0.05). There was a negative correlation between the degree of lung function injury and the blood gas analysis index of PaO_2(r=-0.360, P<0.01).[Conclusion] Through the study of the correlation between lung function and blood gas analysis in patients with pneumoconiosis, it is considered that the stage and age of pneumoconiosis can affect the lung function and blood gas analysis, and is not related to the length of exposure to dust. Lung function damage in pneumoconiosis patients is consistent with blood gas analysis.
[Objective] To investigate the relationship between pulmonary function and blood gas in patients with pneumoconiosis in Zibo City. [Methods ] The pulmonary function and blood gas test were performed in 141 patients with pneumoconiosis, to analyze the relationship between them and the stage of pneumoconiosis, length of service, age. The degree of lung function damage and blood gas analysis was analyzed.[Results] As the stage of pneumoconiosis increased, the pulmonary function indexes of forced expiratory volume in the first second(FEV1), the ratio of FEV1(FEV1%), peak expiratory flow(PEF), carbon monoxide diffusion capacity(DLCO) and blood gas analysis index of arterial partial pressure of oxygen(PaO_2) showed a tendency to decrease(r=-0.395,-0.373,-0.398,-0.373,-0.203, all P<0.05). With the increase of age, the pulmonary function indexes of FEV1 and PEF blood gas analysis index of PaO_2 showed a decreasing trend(r=-0.208,-0.194,-0.219, all P<0.05), and the alveolar and arterial capillary blood and oxygen partial pressure difference[P(A-a)O_2] showed an increasing trend(r=0.186, P<0.05). The indexes of pulmonary function and blood gas analysis were not related to length of service. The blood gas analysis index of PaO_2 was positively correlated with the pulmonary function indexes of FEV1, FEV1%, PEF and DLCO(r=0.312, 0.217, 0.200, 0.232, all P <0.05), while P(A-a)O_2 was negatively correlated with the pulmonary function indexes of FEV1, FEV1%, PEF and DLCO(r=-0.297,-0.167,-0.179,-0.246, all P<0.05). There was a negative correlation between the degree of lung function injury and the blood gas analysis index of PaO_2(r=-0.360, P<0.01).[Conclusion] Through the study of the correlation between lung function and blood gas analysis in patients with pneumoconiosis, it is considered that the stage and age of pneumoconiosis can affect the lung function and blood gas analysis, and is not related to the length of exposure to dust. Lung function damage in pneumoconiosis patients is consistent with blood gas analysis.
引文
[1]中华人民共和国卫生和计划生育委员会.职业性尘肺病的诊断:GBZ70-2015[S].北京:中国标准出版社,2015:1-3.
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[3]多彩虹.Ⅰ期煤工尘肺123例患者劳动能力鉴定中血气分析与肺功能检查的比较[J].中国煤炭工业医学杂志,2013,16(6):973-974.
[4]李强.煤工尘肺肺功能改变和血气分析[J].医学信息,2013,26(16):287.
[5]杨绥刚.尘肺患者肺功能及血气分析[J].内蒙古预防医学,1997,22(1):25.
[6]何升印.尘肺病患者肺功能及血气分析与临床表现的关系[J].职业与健康,2016,32(9):1187-1189.
[7]张文生,王瑞英.100例Ⅰ期矽肺患者的血气分析[J].中国工业医学杂志,2000,13(4):239-240.
[8]肖方威,饶子龙,吴琳.2011年三明市新发尘肺病的肺功能分析[J].中国工业医学杂志,2012,25(5):370-372.
[9]李德鸿.尘肺病[M].北京:化学工业出版社,2010:50.
[10]蔡绍曦,孟颖.慢性气道疾病基层管理500问[M].北京:科学出版社,2017:9-10.
[11]胡晓雷,傅正义,阴旅宁,等.Ⅰ期煤工尘肺患者肺功能与血气测定结果分析[J].职业卫生与伤病,2009,24(4):235-236.
[12]李圣磊,肖友立.尘肺病患者肺功能测定与动脉血气分析的比较分析[J].实用预防医学,2011,18(9):1687.
[13]杨苏文,倪树彬.体检鉴定中影响肺功能与血气分析检查结果的因素分析[J].西南国防医药,2012,22(12):1365-1367.
[14]张敏,陈均强,蒋兆强,等.肺功能检查在职业健康检查和尘肺病诊断中的应用进展[J].中国职业医学,2013,40(1):75-76.
[15]李颖,肖云龙,肖友立,等.肺功能与动脉血气检测在尘肺病劳动能力鉴定中的应用探讨[J].工业卫生与职业病,2016,42(4):267-269.
[2]林潮,林连述,陈雪娇.160例尘肺病患者肺功能与血气分析相关性研究[J].职业卫生与应急救援,2016,34(1):19-21.
[3]多彩虹.Ⅰ期煤工尘肺123例患者劳动能力鉴定中血气分析与肺功能检查的比较[J].中国煤炭工业医学杂志,2013,16(6):973-974.
[4]李强.煤工尘肺肺功能改变和血气分析[J].医学信息,2013,26(16):287.
[5]杨绥刚.尘肺患者肺功能及血气分析[J].内蒙古预防医学,1997,22(1):25.
[6]何升印.尘肺病患者肺功能及血气分析与临床表现的关系[J].职业与健康,2016,32(9):1187-1189.
[7]张文生,王瑞英.100例Ⅰ期矽肺患者的血气分析[J].中国工业医学杂志,2000,13(4):239-240.
[8]肖方威,饶子龙,吴琳.2011年三明市新发尘肺病的肺功能分析[J].中国工业医学杂志,2012,25(5):370-372.
[9]李德鸿.尘肺病[M].北京:化学工业出版社,2010:50.
[10]蔡绍曦,孟颖.慢性气道疾病基层管理500问[M].北京:科学出版社,2017:9-10.
[11]胡晓雷,傅正义,阴旅宁,等.Ⅰ期煤工尘肺患者肺功能与血气测定结果分析[J].职业卫生与伤病,2009,24(4):235-236.
[12]李圣磊,肖友立.尘肺病患者肺功能测定与动脉血气分析的比较分析[J].实用预防医学,2011,18(9):1687.
[13]杨苏文,倪树彬.体检鉴定中影响肺功能与血气分析检查结果的因素分析[J].西南国防医药,2012,22(12):1365-1367.
[14]张敏,陈均强,蒋兆强,等.肺功能检查在职业健康检查和尘肺病诊断中的应用进展[J].中国职业医学,2013,40(1):75-76.
[15]李颖,肖云龙,肖友立,等.肺功能与动脉血气检测在尘肺病劳动能力鉴定中的应用探讨[J].工业卫生与职业病,2016,42(4):267-269.