慢性单纯性矽肺患者肺活量测定结果和六分钟步行测试后氧饱和度与年龄、接触二氧化硅时间、吸烟包年、职业和平均肺动脉压的相关性。

IF 1.1 Q4 RESPIRATORY SYSTEM Monaldi Archives for Chest Disease Pub Date : 2024-09-16 DOI:10.4081/monaldi.2024.3094
Jyoti Kumari, Manish Advani, Gopal Purohit
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引用次数: 0

摘要

矽肺病与可预防但不可逆转的肺损伤有关。对矽肺病工人进行早期量化评估将有助于采取早期干预措施,减少健康恶化。本研究的目的是将慢性单纯性矽肺患者的肺活量测定结果和六分钟步行测试后氧饱和度(post-6MWT OD)与年龄、接触二氧化硅的时间(DSE)、吸烟包年(SPY)、职业和平均肺动脉压相关联。根据对二氧化硅的职业暴露和慢性单纯性矽肺的放射学确认,104 名患者(均为男性)被纳入研究,并根据 SPY(无、1-10、11-20 和大于 20)和职业(钻工和修整工)进行分组。他们接受了肺活量测定、6MWT 后 OD 和经胸超声心动图 (TTE) 的进一步检查,并对检查结果进行了统计分析。在所有病例中,62.5%(65/104)的肺活量检查结果异常,其中大于 20 SPY 组(84%;21/25)和钻孔者(68.3%;28/41)的比例最高。50.96% 的病例(53/104)出现了 6MWT 后 OD,其中 >20 SPY 组(56%;14/25)和钻孔者(63.4%;26/41)的比例最高。正常和限制性模式在 20 SPY 组中占主导地位。正常、阻塞性和限制性模式在穿衣者中占主导地位,而混合模式在钻孔者中占主导地位。平均年龄和平均 DSE 均高于 20 SPY 组和穿衣者、阻塞型和混合型以及 6MWT OD 后的患者。肺动脉高压与肺活量模式异常(69.3%;45/65)和 6MWT 后 OD(79.3%;42/53)明显相关。平均一秒用力呼气量(FEV1)/用力肺活量(FVC)明显低于 >20 SPY 组。平均 FEV1 与 SPY 呈反比关系,钻孔者的平均 FVC 低于修整者。肺活量测定、6MWT 后 OD 和 TTE 评估可全面了解慢性矽肺患者的心肺运动能力,有助于早期干预,特别是对从事机器采矿活动的工人。
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Correlation of spirometry findings and post-six-minute walk test oxygen desaturation in chronic simple silicosis patients with age, duration of silica exposure, smoking pack years, occupation and mean pulmonary artery pressure.

Silicosis is associated with preventable but irreversible lung damage. Early quantifiable assessment of silicosis workers would promote early interventional steps to reduce health deterioration. The objectives of this study were to correlate spirometry findings and post-six-minute walk test oxygen desaturation (post-6MWT OD) in chronic simple silicosis with age, duration of silica exposure (DSE), smoking pack years (SPY), occupation, and mean pulmonary artery pressure. Based on occupational exposure to silica and radiologic confirmation of chronic simple silicosis, 104 patients (all males) were enrolled and grouped based on SPY (nil, 1-10, 11-20, and >20) and occupation (drillers and dressers). They were further investigated with spirometry, post-6MWT OD, and transthoracic echocardiography (TTE), and findings were statistically analyzed. Abnormal spirometry findings were seen in 62.5% of total cases (65/104), with the highest percentage in the >20 SPY group (84%; 21/25) and drillers (68.3%; 28/41). The post-6MWT OD was seen in 50.96% of cases (53/104) with the highest percentage in the >20 SPY group (56%; 14/25) and drillers (63.4%; 26/41). Normal and restrictive patterns were predominant among <20 SPY groups, while obstructive and mixed patterns were prevalent in the >20 SPY group. Normal, obstructive, and restrictive patterns were predominant among dressers, while mixed patterns were in drillers. Mean age and mean DSE were higher for >20 SPY group and dressers; obstructive and mixed patterns; and patients with post-6MWT OD. Pulmonary hypertension was significantly associated with the presence of abnormal spirometry patterns (69.3%; 45/65) and post-6MWT OD (79.3%; 42/53). Mean forced expiratory volume in one second (FEV1)/forced vital capacity (FVC) was significantly lower for the >20 SPY group. Mean FEV1 had an inverse relation with SPY, and mean FVC was lower for drillers than dressers. Spirometry, post-6MWT OD, and TTE assessment give a complete overview of the cardiopulmonary exercise capacity of chronic silicosis patients and facilitate early interventions with special consideration for workers involved in machine-based mining activity.

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