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目的研究尘肺患者慢性阻塞性肺疾病(COPD)的合并率,以及尘肺期别、结核、吸烟、年龄对合并COPD的影响。方法回顾2008年9月—2009年5月在我院住院的292例尘肺患者COPD的合并率,在入院时对其进行支气管舒张试验,凡吸入沙丁胺醇后15min用力呼气容积/用力肺活量(FEV1/FVC)<70%,并排除其他不完全可逆气流受限疾病即诊为尘肺合并COPD。结果尘肺患者COPD合并率为12.33%,尘肺随着期别的增加,合并COPD率也增高,尘肺Ⅲ期合并COPD率高达34.29%。尘肺结核COPD合并率26.15%,明显高于无结核组,差异有统计学意义(χ2=14.79,P<0.01)。有吸烟史烟尘肺合并COPD率与无吸烟史组差异无统计学意义(χ2=1.23,P>0.05)。尘肺患者随着年龄的增加合并COPD率有增高的趋势,70岁以上尘肺合并COPD率高达21.31%。结论尘肺合并COPD率明显高于全国平均水平,职业性粉尘与结核是尘肺合并COPD的危险因素。
Objective To study the combined rate of COPD in patients with pneumoconiosis and the effect of pneumoconiosis, tuberculosis, smoking and age on COPD. Methods The COPD rates of 292 patients with pneumoconiosis who were hospitalized in our hospital from September 2008 to May 2009 were retrospectively analyzed. Bronchodilator test was performed on admission, and the FEV1 / FVC) <70%, and exclude other incomplete reversible airflow limitation disease is diagnosed as pneumoconiosis with COPD. Results The pneumoconiosis patients had a COPD rate of 12.33%. The pneumoconiosis rate increased with the increase of the sepsis. The COPD rate was also increased. The COPD rate of pneumoconiosis stage Ⅲ was as high as 34.29%. The combined rate of COPD in pneumoconiosis was 26.15%, which was significantly higher than that in non-tuberculosis (χ2 = 14.79, P <0.01). There was no significant difference in smoking history between pneumoconiosis combined with COPD rate and non-smoking history group (χ2 = 1.23, P> 0.05). Patients with pneumoconiosis had a trend of increasing COPD with age. The rate of pneumoconiosis with COPD over 70 years old was as high as 21.31%. Conclusions The pneumoconiosis combined with COPD rate is significantly higher than the national average. Occupational dust and tuberculosis are risk factors for pneumoconiosis combined with COPD.