CAJ | 학술논문

目的：探讨影响接尘煤矿工人慢性阻塞性肺疾病临床疗效的因素。方法：选取2010年1月-2013年4月本院呼吸内科住院的93例慢阻肺患者及煤工尘肺患者作为研究对象，将其随机分为接尘煤工慢阻肺组35例、非煤工慢阻肺组30例及煤工尘肺组28例。所有患者填写慢阻肺患者自我评估测试问卷（CAT）评估病情，患者支气管镜检查知情同意书签字后，进行支气管镜检查及活检，通过对各组患者支气管镜下的大体观察及活检组织学改变对比研究；对前两组慢阻肺患者使用相同治疗方案，观察其临床疗效。结果：使用相同治疗方案发现，接尘煤矿慢阻性组的CAT和FEV1均明显低于非煤工慢阻肺组，差异均有统计学意义（P<0.05）。接尘煤矿慢阻肺组的大气道黏膜改变与煤工尘肺组大致相同，但程度较轻。而与非煤工慢阻肺组比较，其表现出特殊变化：如黏膜表面发黑区、管腔狭窄变形、黏膜下纤维组织增生等。结论：支气管形态及组织学改变是导致接尘煤矿工人慢性阻塞性肺疾病患者比相同病情的非煤矿工人慢性阻塞性肺疾病患者的临床治疗效果差的主要原因。
목적：탐토영향접진매광공인만성조새성폐질병림상료효적인소。방법：선취2010년1월-2013년4월본원호흡내과주원적93례만조폐환자급매공진폐환자작위연구대상，장기수궤분위접진매공만조폐조35례、비매공만조폐조30례급매공진폐조28례。소유환자전사만조폐환자자아평고측시문권（CAT）평고병정，환자지기관경검사지정동의서첨자후，진행지기관경검사급활검，통과대각조환자지기관경하적대체관찰급활검조직학개변대비연구；대전량조만조폐환자사용상동치료방안，관찰기림상료효。결과：사용상동치료방안발현，접진매광만조성조적CAT화FEV1균명현저우비매공만조폐조，차이균유통계학의의（P<0.05）。접진매광만조폐조적대기도점막개변여매공진폐조대치상동，단정도교경。이여비매공만조폐조비교，기표현출특수변화：여점막표면발흑구、관강협착변형、점막하섬유조직증생등。결론：지기관형태급조직학개변시도치접진매광공인만성조새성폐질병환자비상동병정적비매광공인만성조새성폐질병환자적림상치료효과차적주요원인。
Objective:To investigate the influence factors on clinical curative effect of workers exposed to dusts with chronic obstructive pulmonary disease(COPD).Method:93 patients with chronic obstructive pulmonary disease and coal-worker’s pneumoconiosis in our hospital from January 2010 and April 2013 were selected as research subjects,they were randomly divided into workers exposed to dusts with chronic obstructive pulmonary disease group (35 cases)and non workers exposed to dusts with chronic obstructive pulmonary disease group(30 cases)and coal-worker’s pneumoconiosis group(28 cases).All patients’ disease were evaluated by COPD assessment test.And patients were treated with bronchoscopy and biopsy after informed consent,the changes of bronchoscope of gross observation and biopsy histology in each group were compared and researched.The first two COPD patients were given the same treatment, and observed its clinical effect.Result:Used the same treatment found that the CAT and FEV1 of workers exposed to dusts with COPD patients were significantly lower than those in non workers exposed to dusts with COPD patients.Large airway mucosa changes of workers exposed to dusts with COPD patients and coal worker's pneumoconiosis patients roughly the same,but to a lesser degree.Compared with non workers exposed to dusts with COPD group,it showed that special change:such as mucosal surface of the black area,deformation of luminal stenosis,submucosal fibrous tissue hyperplasia and so on.Conclusion:Bronchial morphological and histological changes are the main reason lead to the poor clinical therapy effect on workers exposed to dusts with COPD compared with non workers exposed to dusts with COPD in the same condition of COPD.