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本文对88例矽肺病人和37名接尘工人进行了肺功能和动脉血气分析,结果表明各期矽肺的VC、FVC、FEV_1、MMF、FEV_1/FVC均值低于接尘组,而异常检出率则高于接尘组,通气功能的下降呈进行性,但早期不很明显,与接尘组无显著差异。各期矽肺组V_(50)及V_(25)均有明显降低,显示早期即有小气道的广泛损害。矽肺的通气功能损害类型,Ⅰ期矽肺组以阻塞型多见,Ⅱ、Ⅲ期矽肺组以混合型为主。RV和RV/TLC在Ⅲ期矽肺组有明显增高,表明矽肺晚期多并发肺气肿。另外DL_(CD)和K_(CD)在各矽肺组均低于接尘组,差异有显著性,说明矽肺早期即可有弥散功能的损害。血气分析表明PaO_2及SatO_2降低主要见于Ⅱ、Ⅲ期矽肺。Ⅲ期矽肺组有1/3患者(33.33％)在有低氧血症的同时合并有高碳酸血症。对比肺功能和血气分析结果,认为通气功能指标FEV_1、FEV_1/FVC、VC、FVC、MMF以及弥散功能指标DL_(CO)和K_(CO)为早期反映矽肺呼吸功能的灵敏指标。血气分析对病情和预后的判断有重要参考价值。
In this paper, 88 patients with silicosis and 37 workers exposed to dust lung function and arterial blood gas analysis showed that the average of VC, FVC, FEV_1, MMF, FEV_1 / FVC in each stage of silicosis was lower than that of dust exposure group, while the abnormal detection rate Was higher than the dust exposure group, the decline of ventilation function was progressive, but not obvious early, and the dust exposure group no significant difference. The V_ (50) and V_ (25) in all stages of silicosis decreased significantly, which showed extensive damage of small airways in early stage. Silicosis ventilation type of damage, stage I silicosis group to block more common, Ⅱ, Ⅲ silicosis group to mixed-based. RV and RV / TLC in the stage Ⅲ silicosis was significantly higher, indicating that more advanced pulmonary emphysema and pulmonary complications. In addition, DL_ (CD) and K_ (CD) in each silicosis group were lower than the dust exposure group, the difference was significant, indicating that early silicosis may have diffuse damage. Blood gas analysis showed that the decrease of PaO_2 and SatO_2 was mainly found in stage Ⅱ and Ⅲ silicosis. One-third of patients in the stage III silicosis group (33.33%) had hypocapnia combined with hypercapnia. Comparing the results of pulmonary function and blood gas analysis, it is considered that the ventilatory function indexes FEV_1, FEV_1 / FVC, VC, FVC, MMF, and diffusing function indexes DL_ (CO) and K_ (CO) are the sensitive indexes reflecting the respiratory function of Blood gas analysis of the disease and prognosis of judgments have important reference value.