126例矽肺患者预后影响因素及生存期分析  

Analysis of Prognostic Factors and Survival Period in 126 Cases of Silicosis Patients

作　　者：欧海燕 刘素香 OU Haiyan;LIU Suxiang(Outpatient,Zhengzhou Occupational Disease Prevention and Control Hospital,Henan,Zhengzhou 450053,China)

机构地区：[1]郑州市职业病防治院门诊,河南郑州450053

出　　处：《临床研究》2023年第9期74-77,共4页Clinical Research

摘　　要：目的研究126例矽肺患者的预后情况,分析造成预后不良的危险因素。方法回顾性分析2010年5月至2018年12月郑州市职业病防治院收治的126例矽肺患者的研究资料,入院的所有患者均接受解痉、平喘、吸氧、抗感染等基础保守治疗,出院后门诊随访,第1年每3个月随访1次,1年后每6个月随访1次,按是否死亡分为死亡组(n=22例)和存活组(n=104例)。分析死亡组患者的死因及生存期;分析死亡组和存活组患者的工种、开始接尘世间、矽肺期别、接尘工龄、发病年龄、初诊期别,并建立Cox回归模型进行预后多因素回归分析。结果126例患者中死亡22例(17.46%),存活104例(82.54%),患者平均死亡年龄(75.12±6.34)岁,具体死亡原因分别为矽肺、肺癌、肺源性心脏病、肺结核、肺炎、心、脑血管疾病及其他,占比分别为36.36%、18.18%、18.18%、13.64%、4.55%、4.55%、4.55%,患者平均生存期为(17.46±8.69)年。本研究中预后单因素分析显示,死亡组患者接尘工龄≥10年(90.91%)、有吸烟史(77.27%)、有合并肺结核(86.36)的患者比例明显高于存活组(61.54%、51.92%、43.27%),差异有统计学意义(χ^(2)=7.409、5.452、13.493,P<0.05),两组患者性别、年龄、是否有饮酒史、脱尘时间、粉尘性质、矽肺晋期、初诊期别比较,差异无统计学意义(χ^(2)=0.248、0.481、0.050、0.002、0.621、1.818、2.032,P>0.05);Cox回归分析结果提示,患者有吸烟史(β=1.205,OR=3.021,95%CI:1.305~9.236)、接尘工龄≥10年(β=2.136,OR=6.325,95%CI:1.462~45.126)、合并肺结核(β=0.596,OR=1.527,95%CI:1.084~2.126)是患者预后的危险因素,差异有统计学意义(P<0.05)。结论需要特别关注有危险因素的工人,及时进行早期诊断及治疗,指导患者进行戒烟,积极对合并症进行治疗处理,进而改善患者预后。Objective To study the prognosis of 126 patients with silicosis and to analyze the risk factors contributing to poor prognosis.Methods Retrospective analysis of the study data of 126 patients with silicosis admitted to Zhengzhou City Occupational Disease Prevention and Control Hospital from May 2010 to December 2018.All patients admitted to the hospital received basic conservative treatment such as antispasmodic,asthma,oxygen and anti-infection.Outpatient follow-up after discharge,were followed up every 3 months in the first year and every 6 months after 1 year.The patients were divided into a death group(n=22)and a survival group(n=104)according to whether they died.The cause of death and survival of the patients in the death group were analysed;the type of work,duration of dust collection,stage of silicosis,length of dust collection,age at onset and stage of initial diagnosis of the patients in the death and survival groups were analysed,and a Cox regression model was developed for prognostic multifactor regression analysis.Results Of the 126 patients,22 died(17.46%)and 104 survived(82.54%).The mean age at death was(75.12±6.34)years,and the specific causes of death were silicosis,lung cancer,pulmonary heart disease,tuberculosis,pneumonia,cardiac and cerebrovascular diseases and others,accounting for 36.36%,18.18%,18.18%,13.64%and 4.55%,4.55%and 4.55%respectively,and the mean survival of patients was(17.46±8.69)years.In this study,univariate analysis of prognosis showed that the proportion of patients in the death group who had been exposed to dust for≥10 years(90.91%),had a history of smoking(77.27%),and concurrent pulmonary tuberculosis(86.36%)were significantly higher than those in the survival group(61.54%,51.92%,43.27%),and the difference was statistically significant(χ^(2)=7.409,5.452,13.493,P<0.05),and there was no statistical difference between the two groups in terms of gender,age,history of alcohol consumption,time of dust removal,nature of dust,stage of pneumoconiosis advancement,and stage of ini

关 键 词：矽肺 生存期 预后 危险因素 

分 类 号：R135.2[医药卫生—劳动卫生]