Objective: To investigate the clinical features of pneumoconiosis complicated with pulmo-nary emphysema. Methods: selected 868 patients with pneumoconiosis were selected from December 2015 to December 2016 in Hunan occupational disease prevention and treatment hospital. Collected the results of high-resolution spiral CT, arterial blood gas, ECG, pulmonary function and MRC score. The subjects were divided into pneumoconiosis complicated with pulmonary emphysema group and simple pneumoconiosis group accord-ing to the results of HRCT. The smoking, MRC score, pulmonary function, blood gas and complications were compared. Results: A total of 868 patients were enrolled in the study. Emphysema 232 people, accounting for 26.73%. The incidence of emphysema in the first phase of pneumoconiosis was 12.69%, and the incidence rate of emphysema in pneumoconiosis was 17.03%, The incidence of three Stage pneumoconiosis was highest, up to 60.76%, the incidence of emphysema increased with the increase of stages of pneumoconiosis (P=0.000) .The smoking index of pneumoconiosis combined with emphysema group was significantly higher than that of simple pneumoconiosis group (P<0.01) . The MRC score of pneumoconiosis complicated with pulmonary em-physema group was higher than that of simple pneumoconiosis group (P=0.000) . In pneumoconiosis complicat-ed with pulmonary emphysema group the FEV(1.0)%, FVC%, FEV(1.0)/FVC, DLCO%, oxygen partial pressure were significantly lower than that of simple pneumoconiosis group (P≤0.05) . The combined rate of Bullae of lung in pneumoconiosis complicated with pulmonary emphysema group was higher than that of simple pneumo-coniosis group (P<0.01) . Conclusion: pneumoconiosis stage and smoking. Patients with pneumoconiosis com-plicated with pulmonary emphysema had heavier breathing difficulties, more serious pulmonary function and active endurance, the degree of hypoxia is more serious, and had a higher incidence of complications. The pul-monary function of pneumoconiosis complicated with pulmonary emphysema is not consistent with the typical CPFE.
目的： 探讨尘肺病并发肺气肿的临床特点。 方法： 选取2015年12月至2016年12月在湖南省职业病防治院就诊的868例尘肺病患者。收集其高分辨螺旋CT、动脉血气、心电图、肺功能、MRC评分的结果。将研究对象按HRCT结果是否并发肺气肿分为尘肺并发肺气肿组与单纯尘肺组进行比较，对比其吸烟、MRC评分、肺功能、血气及并发症等指标。 结果： 研究对象共868人，并发肺气肿232人，占26.73%。Ⅰ期尘肺的肺气肿发生率为12.69%，Ⅱ期尘肺的肺气肿发生率为17.03%，Ⅲ期尘肺的发生率最高，为60.76%，肺气肿的发生率随着尘肺期别的增加而增加，差异有统计学意义（P<0.01）。尘肺并发肺气肿组吸烟指数和呼吸困难评分均明显高于单纯尘肺组，差异有统计学意义（P<0.01）。尘肺并发肺气肿组FEV(1)%、FVC%、FEV(1)/FVC、DLCO%、氧分压均较单纯尘肺组明显降低，差异有统计学意义（P<0.05）。尘肺并发肺气肿组肺大泡发生率明显高于单纯尘肺组，差异有统计学意义（P<0.01）。 结论： 尘肺期别、吸烟是尘肺病并发肺气肿的危险因素。尘肺病并发肺气肿患者较单纯尘肺病患者呼吸困难更重、活动耐力及肺功能更差、缺氧程度更重，而且其并发症发生率高。.
Keywords: Emphysema; Pneumoconiosis; Pulmonary fibrosis.