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| 題 名 | Ventilatory Defect in Coal Workers with Simple Pneumoconiosis: Early Detection of Functional Abnormalities=單純煤礦工塵肺症之換氣障礙:功能異常的早期表現 |
|---|---|
| 作 者 | 林凌芝; 楊錫欽; 盧國輝; | 書刊名 | The Kaohsiung Journal of Medical Sciences |
| 卷 期 | 17:5 2001.05[民90.05] |
| 頁 次 | 頁245-252 |
| 分類號 | 415.465 |
| 關鍵詞 | 煤礦工塵肺症; 換氣障礙; Coal workers' pneumoconiosis; Airway obstruction; Early detection; Compensation; |
| 語 文 | 英文(English) |
| 中文摘要 | 氣道阻塞在煤礦工塵肺症時是一相當明顯的症候,然而許多患單純塵 肺症之煤礦工,其用力肺活量( forced vital capacity, FVC ) 與一秒量( forced expiratory volume in 1s, FEV1 )卻為正常。為了早期偵測這些呼吸障害不明顯之患 者的功能變化,本研究乃試圖尋找其他的肺功能指標,以期能確實反映此一族群 的通氣異常。本研究針對227名胸部X光片證實罹患單純塵肺症之礦工進行最 大流速─容積圖形測定,並另外觀察其殘氣量( residual volume, RV ) 及功能性肺 餘量( functional residual capacity, FRC ) 的改變。塵肺症的X光表現依照國際勞 工組織所訂定的標準加以分類。肺量測定若顯現FEV1/ FVC < 70%,即認為有氣 道阻塞。結果顯示52.9%之單純煤礦工塵肺症患者有氣道阻塞。無氣道阻塞者其 FVC及FEV1雖然正常,但進一步分析卻顯示其FRC及RV,卻已隨著X光等 級逐漸增加,而max50及FEF25-75 %則逐漸下降( p < 0.05 )。max75及PEFR並 無明顯變化。有氣道阻塞的患者,其上述各項肺功能參數亦有類似變化的傾向, 而且FRC與RV上升的幅度,與max50及FEF25-75 %降低的幅度均比無氣道阻 塞者為大( p < 0.05 )。但FRC只有在X光等級3之無氣道阻塞的病患,才略為接 近異常升高的標準。吸菸的因素並不能完全解釋這些差異,因為有氣道阻塞與無 阻塞二組間,吸菸者的比率相近,而且各X光等級患者間吸菸的暴露劑量並無 統計學上的差異。本文的結論是無氣道阻塞之單純煤礦工塵肺症患者其FVC與 FEV1雖為正常,但測量RV,max50與FEF25-75 %仍可能偵測到比較輕微的功 能變化,而這些變化似乎與煤斑沉著於呼吸道末端有關。 |
| 英文摘要 | Airway obstruction is a prominent feature in coal workers?pneumoconiosis ( CWP). However, many patients with CWP have even demonstrated a normal forced vital capacity (FVC) and forced expiratory volume in 1s (FEV1). The purpose of this study was to evaluate the ventilatory defect by spirometry and search for parameters, other than FVC and FEV1, suitable for early detection of pulmonary impairment in CWP. A sample of 227 coal miners was selected from the medical clinics of two teaching hospitals. Maximal expiratory flow volume measurement and determination of functional residual capacity (FRC) and residual volume (RV) were carried out with an automated plethysmograph. The prevalence of airway obstruction (FEV1/FVC < 70 %) in this sample of miners was 52.9% ( 120 / 227 ). There was a progression of functional impairment with the transition from category 0 to categories 2 and 3, no matter what the miners smoking habits. All of the 107 non-obstructed miners had a normal FVC and FEV1. However, the mean values for FEF25-75% (mean forced expiratory flow during the middle half of FVC)and Vmax50 (maximal expiratory flow rate at 50% FVC) were abnormally low, and RV was already elevated, in those non-obstructed subjects with category 1 simple pneumoconiosis. A borderline abnormally elevated FRC in the miners with radiological category 3 of CWP was also noted. We conclude that the Vmax50, FEF25-75%, and RV appeared to be the discriminative indices for detecting early ventilatory defect in non-obstructed patients with simple CWP. Further studies is still needed to clarify the cause of small airway dysfunction. |
本系統中英文摘要資訊取自各篇刊載內容。