じん肺X線重症度のスコア評価法と肺機能との関連性

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The evaluation of radiographic findings of pneumoconiosis with massive fibrosis has been done by the size of the large opacities (A, B, C). This procedure, however, was not satisfactory to understand its severity. The severity of pneumoconiosis on the radiogram is detected not only by the size of large opacities but also by the various complications of the pathologic changes of the lung, e.g., fibrotic and emphysematous changes, etc. In this study, the integrated method of scoring the radiographic findings on the basis of the sorts and the development of the pathologic changes was carried out and the correlation between this score evaluation and the pulmonary function was statistically analyzed. 1. The classification and the scoring of the radiographic findings of pneumoconiosis On the radiographic appearance of pneumoconiosis, rounded opacities were classified into 7 (p/p〜r/r) for the type and 11 (0/0〜3/+) for the profusion. As to large opacities, 4 (ax/ax〜M/M) for the coalescence, 10 or more (1×1〜10×10 cm) for the size, 4 (id/id〜wd/wd) for the definition of the border and also 4 (out〜inside) for the position in the lung field. As to pleural thickening, 3 (a〜c) for the width and 2 (1, 2) for the extent. As to diaphragmatic adhesion, 3 (slightly〜far advanced). On the radiographic findings mentioned above, one mark was given to every class. Irregular opacities, emphysematous and hilar changes were classified into 3 (slightly〜far advanced), and three marks were given to every class. 2. The examination of the validity of score evaluation Making use of 4 standard films prepared, 5 chest physicians diagnosed and scored 7 test films of pneumoconiosis by the above method and also ranked them visually on the radiographic severity. These two procedures corresponded well. 3. The correlation between the score evaluation and the pulmonary function 117 ceramic workers with pneumoconiosis have been examined by spirometries, flow volume curve test and subjective symptoms. The correlations between the total scores on the basis of the various radiographic findings and the values of %VC, FEV_<1.0>%, %FEV_<1.0>, FEV_<1.0>/VCpre, %MMF, %V_<50>, %V_<25>, V_<25>/h/pre, Exersise Index and Ventilative Index were statistically significant (p<0.01). Whereas, Po_2 and AaDo_2 were not correlated with the score. The validity of this score evaluation was higher than that of the usual classification [PR_3, PR_4 (A), (B)] on the relation to the pulmonary function. It was suggested especially that the values of %FEV_<1.0>, FEV_<1.0>/VCpre and %V_<50> were useful to demonstrate the severity of pneumoconiosis. Above all, the scoring of emphysematous and fibrotic findings showed high correlation. This indicated that the pulmonary insuffciency of pneumoconiosis was more markedly effected by the extensive lung desolation leading to emphysema, pulmonary fibrosis and other complicated lesions than by the size of large opacities or the profusion of rounded opacities. It was concluded that the scoring system of the radiographic findings was very useful for evaluating the radiographic severity of pneumoconiosis.
社団法人日本産業衛生学会の論文
1980-07-20

じん肺X線重症度のスコア評価法と肺機能との関連性

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