铬酸盐接触工人肺通气功能的动态观察

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目的:探讨铬酸盐接触对工人肺通气功能的影响。方法:选择河南省某铬酸盐生产企业铬酸盐接触的95人为接触组,非铬酸盐接触的42人为对照组,于2010年冬季和2011年冬季,进行了连续2次职业健康体检,比较该人群肺通气功能的变化。结果:2010年铬酸盐接触组与对照组比较,发现肺通气功能指标用力肺活量[forcedvital capacity,FVC,(75.38±15.23)L vs.(83.99±26.52)L]、一秒用力呼气容积[(forced expiratory volume in onesecond,FEV1,(82.13±16.51)L vs.(91.24±30.03)L]、用力肺活量/一秒用力呼气容积(FEV1/FVC,112.10±13.23 vs.116.18±11.32)、呼气峰值流速[peak expiratory flow,PEF,(74.31±28.09)L vs.(78.13±28.34)L]、最大呼吸流量[maximal expiratory flow,MEF,(101.23±46.37)L/s vs.(110.02±41.40)L/s]、每分钟最大通气量[maximum ventilation volume,MVV,(90.82±16.89)L/min vs.(99.95±22.61)L/min]均显著下降(P<0.05)。2011年铬酸盐接触组与对照组比较,肺通气功能指标FVC[(72.34±14.18)L vs.(81.01±20.79)L)、FEV1[(76.04±16.20)L vs.(86.71±24.53)L]、FEV1/FVC(109.10±16.18 vs.114.08±10.79)、PEF[(71.35±24.87)L/s vs.(75.36±20.67)L/s)、MEF[(96.51±30.17)L/s vs.(107.11±34.81)L/s]、MVV[(84.85±21.22)L/minvs.(96.77±22.63)L/min]亦有显著下降(P<0.05),并且2011年与2010年相比较,接触组肺通气功能指标FEV1[(76.04±16.20)L vs.(82.13±16.51)L]、MEF[(96.51±30.17)L/s vs.(101.23±46.37)L/s]、MVV[(84.85±21.22)L/min vs.(90.82±16.89)L/min]均显著下降(P<0.05)。由FVC、FEV1、FEV1/FVC,这3种指标对肺功能损伤进行分级和分型发现,接触组损伤程度的分布与对照组无区别,而损伤类型则以限制型为主,且未观察到随时间的变化。对铬酸盐接触工人进行工种分层分析后发现,不同工种肺功能差异有统计学意义,提示工种对肺功能损伤影响显著。结论:提示长期铬酸盐接触对肺通气功能损伤明显,并受工种影响显著。 Objective: To investigate the effect of chromate exposure on pulmonary ventilation in workers. Methods: Ninety-five contact groups of chromate in a chromate production enterprise in Henan Province and 42 non-chromate exposure groups were selected as control group. During the winter of 2010 and the winter of 2011, two consecutive occupational health examinations were conducted, Compare the changes of lung ventilation function in this population. Results: Compared with the control group, the lung ventilation index of forced ventilation (FVC, (75.38 ± 15.23) L vs. (83.99 ± 26.52) L], forced expiratory volume in one second [ (forced expiratory volume in one second, FEV1, (82.13 ± 16.51) L vs. (91.24 ± 30.03) L], forced vital capacity per second forced expiratory volume (FEV1 / FVC, 112.10 ± 13.23 vs.116.18 ± 11.32) Peak expiratory flow (PEF, (74.31 ± 28.09) L vs. (78.13 ± 28.34) L], maximal expiratory flow, MEF, (101.23 ± 46.37) L / s vs. (110.02 ± 41.40 ) L / s] and maximum ventilation volume (MVV, (90.82 ± 16.89) L / min vs. (99.95 ± 22.61) L / min] Compared with the control group, the values ​​of FVC (72.34 ± 14.18) L vs. (81.01 ± 20.79) L, FEV1 [(76.04 ± 16.20) L vs. (86.71 ± 24.53) L], FEV1 / FVC (109.10 ± 16.18 vs.114.08 ± 10.79), PEF [(71.35 ± 24.87) L / s vs. (75.36 ± 20.67) L / s), MEF [(96.51 ± 30.17) L / s vs. (107.11 ± 34.81 ), MVV [(84.85 ± 21.22) L / min vs (96.77 ± 22.63) L / min] also decreased significantly (P <0 .05), and compared with 2010, FEV1 [(76.04 ± 16.20) L vs. (82.13 ± 16.51) L], MEF [(96.51 ± 30.17) L / s vs. 101.23 ± 46.37) L / s] and MVV [(84.85 ± 21.22) L / min vs. (90.82 ± 16.89) L / min) FVC, FEV1, FEV1 / FVC, these three kinds of indicators of lung function damage classification and sub-type found that the contact group injury distribution and control group no difference, while the type of injury is limited mainly without observed Change over time. Chromium exposure workers were stratified analysis of the type of work found that different types of lung function difference was statistically significant, suggesting that the type of work on lung function damage significantly. Conclusion: It suggests that long-term chromate exposure has obvious damage to pulmonary ventilation and is significantly affected by the type of work.
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