煤礦工人的通氣功能研究

煤礦工塵肺症（coal workers' pneumoconiosis，CWP）在臨床上會引發多種肺功能異常。為探討台灣礦工CWP患者之通氣障礙型態，本文針對98位煤礦工，依其X光表現並按照國際勞工組織所訂定的標準予以分類，計得無塵肺陰影者（category 0）25位，單純塵肺症（simple pneumoconiosis）者49位，進行性重度肺纖維化（progressive massive fibrosis，PMF）者24位。所有礦工均接受通氣功能、肺容積及氣道阻力測定。觀察的結果顯示CWP患者整體的用力肺活量（forced vital capacity，FVC）及全肺量（total lung capacity，TLC）並無異常；但一秒量（forced expiratory volume in one second，FEV1），一秒率（FEV1/FVC），及呼氣速率參數（maximal expiratory flow rate at 75% and 50% FVC，Vmax 75與Vmax 50）均有低下的現象。單純塵肺症患者約有一半（49%）其最大呼氣流速容積曲積線為正常，43%顯現阻塞型通氣障礙，而且此一分佈狀況與X光小陰影形狀（線狀與粒狀）分類無關。用力肺活量在PMF患者才有明顯的下降（至預測值的58.1±17.3%）。氣道阻力在所有煤礦工，包括X光無塵肺陰影者，均有上升，且其幅度隨著X光等級而加大。本文的結論是台灣CWP在肺功能上是以阻塞型通氣障礙為主要表徵，但不能排除抽煙之因素。

關鍵字

煤礦工塵肺症；通氣障礙；肺功能

並列摘要

Clinically, coal workers’ pneumoconiosis (CWP) may result in several pulmonary functional abnormalities. In order to further understand the patterns of ventilatory defect of patients with CWP in Taiwan, this study collected 98 coal miners including 25 with X-ray category 0, 49 with simple pneumoconiosis and 24 with progressive massive fibrosis (PMF)。Tests were conducted to determine their ventilatory function, lung volumes and airway resistance (Raw). Our data revealed that patients with CWP demonstrated a normal FVC (forced vital capcity) and a normal TLC (total lung capacity). However, expiratory flow parameters such as FEV1 (forced expiratory volume in 1s) and FEV1/FVC were decreased. The maximal expiratory flow-volume curves in approximately half (49%) of the patients with simple pneumoconiosis were normal, and were of a obstructive pattern in simple pneumoconiosis. Remarkable reduction in FVC and TLC were observed mainly in patients with PMF. However, Raw was consistently elevated in all groups, even in patients with category 0 of CWP. We conclude that CWP in Taiwan, from functional point of view, is primarily manifested with an obstructive ventilatory defect.

並列關鍵字

coal workers' pneumoconiosis ； ventilatory defect ； pulmonary function

國際替代計量

煤礦工人的通氣功能研究

未授權

主題瀏覽