【摘要】 本文依据弥漫性纤维化的范围和严重度,提出了石棉肺的病理诊断标准和分期方案.按此标准,对国内主要石棉厂矿的50例接尘工人尸检资料试行回顾性病理分期.结果是:16例未见石棉肺,虽在呼吸细支气管部位镜下可能出现轻微尘性病变;确诊为石棉肺Ⅰ期20例,Ⅱ期10例,Ⅲ期4例.病理分期与X线分期比较,Ⅱ、Ⅲ期符合率分别达70%和100%,而早期病例则符合率颇低.50例中,与石棉相关的其它病变,如胸膜斑见于30例,且有些累及面十分宽广;肺癌和恶性胸膜间皮瘤(仅1例)共18例(36%).作者认为,这些与石棉相关的严重和致命的病损全都应视为职业性疾患,此类病人应当享受职业病待遇.更多还原

【Abstract】 A 3-stage grading scheme of asbestosis and its pathological diagnostic criteria are proposed on the basis of the extent and severity of diffuse fibrosis. The proposed criteria were used in the retrospective pathological grading of autopsy data of 50 asbestos-exposed workers from the main asbestos mines and textile mills in China. The results showed that no asbestosis was noticed 5n 16 cases in spite of mild dust changes in the respiratory bronchioles microscopically. Among the established cases,20 were of stage 1,10 of stageⅡ, and 4 of stage Ⅲ according to the proposed grading scheme. The consistency rates were found to be as high as 70% and 100% in stageⅡand stage Ⅲ cases respectively when compared with the grading by pathological stages and radiological stages. However, the consistency rate was rather low in the early stage. Among other asbestos-related lesions also seen in the 50 cases were pleural plaques (30 cases,) with some even spreading extensively, lung cancer and malignant pleural mesothelioma(l8 cases, with the latter found only in 1 case),accounting for 36%. The authors hold that these serious and fatal asbestos-related lesion should be regarded as occupational diseases and such patients be compensated.更多还原