血清白蛋白水平与男性尘肺患者重度以上肺通气功能障碍发生风险的关联研究  

Study on associations of serum albumin levels with risk of severe or very severe pulmonary ventilation dysfunction in male pneumoconiosis patients

作　　者：魏宇豪 彭姗姗 刘丽芳 喻文鳌 周丁子 廖加强 张勤 姚于勤 张本 杜文 WEI Yu-hao;PENG Shan-shan;LIU Li-fang;YU Wen-ao;ZHOU Ding-zi;LIAO Jia-qiang;ZHANG Qin;YAO Yu-qin;ZHANG Ben;DU Wen(West China Occupational Pneumoconiosis Cohort Study(WCOPCS)workgroup,West China School of Public Health and West China Fourth Hospital,Sichuan University,Chengdu,Sichuan 610041,China)

机构地区：[1]四川大学华西公共卫生学院/华西第四医院,华西职业性尘肺病队列工作组,四川成都610041

出　　处：《现代预防医学》2024年第10期1914-1920,共7页Modern Preventive Medicine

基　　金：国家自然科学基金区域创新发展联合基金项目(U22A20359,U23A20495);四川省科技厅自然科学基金项目(2023NSFSC0647,2023NSFSC1729)。

摘　　要：目的通过研究血清白蛋白水平与男性尘肺患者重度以上肺通气功能障碍发生风险的关联,为控制或延缓男性尘肺患者肺通气功能的下降提供参考依据。方法本研究采用回顾性队列设计,选取2012年1月—2021年12月间于华西第四医院住院,且基线未合并肺通气功能障碍的男性尘肺患者为研究对象,采用Cox比例风险回归模型计算HR及95%CI以评估基线血清白蛋白水平与重度以上肺通气功能障碍发生风险的关联,采用限制性立方样条图来探究基线血清白蛋白浓度与重度以上肺通气功能障碍发生风险是否存在剂量反应关系。结果本研究共纳入746名研究对象。Cox比例风险回归分析的完全调整模型结果显示,与血清白蛋白低于34.4 g/L的男性尘肺患者相比,血清白蛋白高于40.8g/L的男性尘肺患者发生重度以上肺通气功能障碍的风险降低(HR=0.660,95%CI:0.439~0.992)。限制性立方样条图显示,随着血清白蛋白浓度的逐渐增加,男性尘肺患者发生重度以上肺通气功能障碍的风险逐渐降低,男性尘肺患者的基线血清白蛋白浓度与重度以上肺通气功能障碍的发生风险呈线性负相关(P<0.05)。结论高血清白蛋白是男性尘肺患者发生重度以上肺通气功能障碍的保护因素,维持其血清白蛋白浓度高于40.8 g/L,可降低其重度以上肺通气功能障碍的发生风险。Objective To provide reference for controlling or delaying the decline of pulmonary ventilation function in male pneumoconiosis patients by studying associations of serum albumin levels with the risk of severe or very severe pulmonary ventilation dysfunction in male pneumoconiosis patients.Methods A retrospective cohort design was adopted in this study.Male pneumoconiosis patients who were hospitalized in West China Fourth Hospital from January 2012 to December 2021 and did not have pulmonary ventilation dysfunction at baseline were selected as the study objects.Cox proportional hazard regression models were used to calculate HRs and 95%CIs to evaluate the association of baseline serum albumin levels and the risk of severe or very severe pulmonary ventilation dysfunction.Restricted cubic spline plot was used to explore whether there was a dose-response relationship between baseline serum albumin concentrations and the risk of severe or very severe pulmonary ventilation dysfunction.Results A total of 746 subjects were included in this study.Fully adjusted model results of Cox proportional hazard regression analysis showed that male pneumoconiosis patients with serum albumin higher than 40.8 g/L had a reduced risk of severe or very severe pulmonary ventilation dysfunction compared with male pneumoconiosis patients with serum albumin lower than 34.4g/L(HR=0.660,95%CI:0.439-0.992).The restricted cubic spline figure showed that the risk of severe or very severe pulmonary ventilation dysfunction in male pneumoconiosis patients gradually decreased with the gradual increase of serum albumin concentrations and there was a linear negative relationship between baseline serum albumin concentrations and the incidence risk of severe or very severe pulmonary ventilation dysfunction in male pneumoconiosis patients(P<0.05).Conclusion Higher serum albumin is a protective factor for severe or very severe pulmonary ventilation dysfunction in male pneumoconiosis patients and maintaining the serum albumin concentrations above 40.8 g/L

关 键 词：高血清白蛋白 男性尘肺患者 重度以上 肺通气功能障碍 保护因素 

分 类 号：R135.2[医药卫生—劳动卫生]