Medicina v Kuzbasse (Apr 2021)
PNEUMOCONIOSIS AS A SYSTEM PROCESS IN PULMONARY HISTION
Abstract
Objective – identification of signs of the systemic nature of the pneumoconiotic process in the pulmonary histione, which could be evidence of its development even before the X-ray manifestation. Methods. A histological and morphometric study of the pulmonary histion, arteries and veins of the pulmonary circulation, obtained during 50 forensic medical examinations of a group of miners who died simultaneously while working in a mine during a man-made disaster, was carried out. The control group (CC) was formed from 20 cases of forensic medical examinations of men in Novokuznetsk who died in a road accident. Statistical processing of the results was carried out using the Student's t-test for paired measurements; comparison of the frequency distribution of cases in the observation groups – by the value of χ2. Correlation analysis was performed to identify the relationship between the indicators. Results. The formation of anthracosilicosis in the respiratory structure of the lungs is shown. The formed changes in the bronchial wall correspond to the concept of «atrophic bronchopathy» as a specific manifestation of the coniotic process. Endotheliosis and hypertrophy of smooth muscle cells of the pulmonary arteries are one of the initial manifestations of the coniotic process. Hypertrophy of smooth muscle elements in the bronchi and pulmonary vessels is combined with pronounced peribronchial and perivascular sclerosis and can be considered a manifestation of the coniotic process. Conclusions. The simultaneous development of anthracosilicosis, atrophic bronchopathy, hypertrophy of smooth muscle cells in the pulmonary vessels and bronchi indicates the pathogenetic commonality of changes in the air-conducting structures, vessels of the pulmonary circulation and respiratory tissue and testifies to the consistency of the coniotic process. Hemodynamic and / or histological signs of interest of the vessels of the pulmonary circulation in combination with atrophic bronchopathy can be considered as diagnostic criteria for anthracosilicosis at its pre-X-ray stage.
