摘要
目的通过系统性综述现有文献,探讨快进型矽肺的流行病学特征、影像学表现、肺功能变化、相关粉尘暴露情况及其治疗和预后。方法于2024年12月,通过中国知网(CNKI)、万方数据库、维普数据库、EMbase和PubMed数据库检索1965年1月1日至2024年12月15日的相关文献,中英文检索词:"快速进展性矽肺""快速进展性尘肺病""快进型矽肺""快矽肺""进展性大块纤维化""亚急性矽肺""急进型矽肺""人造石矽肺""accelerated silicosis""rapidly progressive silicosis""rapidly progressive pneumoconiosis""subacute silicosis""artificial stone"等。通过纳入、阅读和提取文献中的数据,对快进型矽肺流行病学、临床特征、治疗预后等情况进行分析。结果共纳入72篇文献,其中队列研究23篇、病例报告28篇、病例对照研究3篇、横断面研究18篇。共计1794例快进型矽肺患者,平均年龄33.67岁,平均接尘时间5.58年。发病工人主要集中于石材加工、采矿、宝石加工等行业。影像学显示为小结节影、磨玻璃影、斑片影、团块影、肺气肿/肺大疱等表现。早期抗纤维化治疗可明确延缓疾病进展。工人工作场所粉尘浓度明显超标,且现场通风差,缺乏有效的防护设施与意识。结论快进型矽肺发病快、进展快、预后差,但目前仍未得到足够重视,亟需可靠的标准和指南指导临床诊疗。
Objective To explore the epidemiological characteristics,imaging findings,pulmonary function changes,dust exposure situations,and treatment outcomes of accelerated silicosis through an analysis of existing literature.Methods In December 2024,relevant literature from January 1,1965 to December 15,2024 was retrieved through the China National Knowledge Infrastructure(CNKI),Wanfang Database,VIP Database,EMbase,and PubMed databases.Keywords included"rapidly progressive silicosis""accelerated silicosis""subacute silicosis""artificial stone"and related terms.By incorporating,analyzing,and retrieving data from literatures,a comprehensive review of the epidemiology,clinical features,treatment options,and prognosis of fast forward silicosis was conducted.Results A total of 72 literatures were included,including 23 cohort studies,28 case reports,3 case-control studies,and 18 cross-sectional studies.The average age of all 1794 patients was 33.67 years,with an average dust exposure duration of 5.58 years.The primary occupations associated with accelerated silicosis were stone processing,mining,and artificial quartz stone manufacturing.Imaging findings predominantly included small nodules,ground-glass opacities,and massive fibrosis.Antifibrotic treatment at the early stage of the disease could clearly delay disease progression.However,dust concentrations in workplaces were significantly above safety limits,with inadequate protective measures.Conclusion Accelerated silicosis is characterized by its rapid onset,swift progression,and unfavorable prognosis.However,it has not garnered adequate attention in the present context.Reliable standard and guidelines are urgently needed to guide clinical diagnosis and treatment.
作者
黄莉敏
周韶炜
陈子丹
施瑾
卞陆琴
毛翎
Huang Limin;Zhou Shaowei;Chen Zidan;Shi Jin;Bian Luqin;Mao Ling(Department of Pneumoconiosis,Shanghai Pulmonary Hospital,Tongji University,Shanghai 200433,China)
出处
《中华劳动卫生职业病杂志》
北大核心
2025年第6期401-409,共9页
Chinese Journal of Industrial Hygiene and Occupational Diseases
基金
国家卫生健康委法规司《职业性尘肺病诊断标准》修订项目(20241203)。
关键词
矽肺
流行病学
快进型矽肺
人造石
喷砂
矿工
抗纤维化
Silicosis
Epidemiology
Accelerated silicosis
Artificial stone
Sandblasting
Miners
Antifibrotic treatment
