广州市尘肺病患者生存分析及影响因素研究  

Study on survival analysis and influencing factors of pneumoconiosis patients in Guangzhou

作　　者：刘慧婷 郑柏宁 莫秋英 廖阳[1] Liu Huiting;Zheng Boning;Mo Qiuying;Liao Yang(Department of Occupational Hygiene Management,Guangzhou Occupational Disease Prevention and Treatment Hospital,Guangzhou 510620,China;Department of Tuberculosis Control and Management,Guangzhou Chest Hospital,Guangzhou 510095,China;School of Medical Technology,Guangdong Medical University,Dongguan 523808,China)

机构地区：[1]广州市职业病防治院职业卫生管理科,广州510620 [2]广州市胸科医院结核病控制管理科,广州510095 [3]广东医科大学医学技术学院,东莞523808

出　　处：《中华劳动卫生职业病杂志》2024年第11期825-830,共6页Chinese Journal of Industrial Hygiene and Occupational Diseases

基　　金：广州市卫生健康科技项目(20241A011057);广东省医学科学技术研究基金项目(A2022310)。

摘　　要：目的分析1958至2018年广州市尘肺病患者的生存情况,探讨尘肺病生存的影响因素,为制定尘肺病救治救助规划提供科学依据。方法于2019年7月至2020年1月,以1958年6月1日至2018年12月31日广州市具有尘肺病诊断资质的机构诊断的1194例职业性尘肺病患者为研究对象。排除258例缺乏生存数据的患者,936例患者纳入尘肺病生存分析。用寿命表法估计生存率,Kaplan-Meier法绘制生存曲线,log-rank检验进行组间比较,以及Cox比例风险回归模型分析生存的影响因素。结果广州市尘肺病患者10、20和30年的累积生存率分别是62.8%、35.2%和15.4%,中位生存时间为19.4年。log-rank检验显示,未合并肺结核与合并肺结核的尘肺病患者的生存曲线差异有统计学意义(P<0.001),不同的尘肺病分期、尘肺病分类之间差异均有统计学意义(P<0.001)。开始接尘年龄(HR=1.03,95%CI:1.01~1.05)、诊断年龄(HR=1.02,95%CI:1.00~1.04)、合并肺结核(HR=1.46,95%CI:1.18~1.81)、尘肺病分期(叁期比壹期,HR=2.26,95%CI:1.47~3.48)和尘肺病分类(致纤维化矿物性粉尘尘肺与金属粉尘尘肺,HR=2.45,95%CI:1.61~3.74;非致纤维化矿物性粉尘尘肺与金属粉尘尘肺,HR=2.67,95%CI:1.47~4.87;混合性尘肺与金属粉尘尘肺,HR=2.25,95%CI:1.11~4.56)均是尘肺病患者生存时间的影响因素(P<0.05)。结论合并肺结核可能增加尘肺病患者的死亡风险,矿物性粉尘尘肺、混合性尘肺,以及尘肺叁期的尘肺病患者也可能具有更高的死亡风险。ObjectiveTo analyze the survival of pneumoconiosis patients in Guangzhou from 1958 to 2018,explore the factors affecting the survival of pneumoconiosis,and provide scientific basis for formulating the guidelines and policies for treatment and assistance of pneumoconiosis.MethodsFrom July 2019 to January 2020,1194 cases of occupational pneumoconiosis patients diagnosed by institutions qualified for pneumoconiosis diagnosis in Guangzhou from June 1,1958 to December 31,2018 were studied.Excluding 258 patients who lacked survival data,936 patients were included in the pneumoconiosis survival analysis.Life table method was used to estimate the survival rate,Kaplan-Meier method was used to draw the survival curve,log-rank test was used to compare the groups,and Cox proportional risk regression model was used to analyze the influencing factors of survival.ResultsThe 10,20 and 30 years cumulative survival rates of pneumoconiosis patients in Guangzhou were 62.8%,35.2%and 15.4%,respectively.The median survival time was 19.4 years.log-rank test showed that there were statistically significant differences in the survival curves of pneumoconiosis patients between group without tuberculosis and group with tuberculosis(P<0.001),and there were statistically significant differences among different stages and categories of pneumoconiosis(P<0.001).Age of exposure to dust(HR=1.03,95%CI:1.01-1.05),age of diagnosis(HR=1.02,95%CI:1.00-1.04),combined pulmonary tuberculosis(HR=1.46,95%CI:1.18-1.81),stage of pneumoconiosis(stageⅢvs.stageⅠ,HR=2.26,95%CI:1.47-3.48)and categories of pneumoconiosis(fibrogenic mineral dust pneumoconiosis and metallogenic pneumoconiosis,HR=2.45,95%CI:1.61-3.74;non-fibrogenic mineral pneumoconiosis and metallogenic pneumoconiosis,HR=2.67,95%CI:1.47-4.87;mixed pneumoconiosis and metallogenic pneumoconiosis,HR=2.25,95%CI:1.11-4.56)were the factors affecting the survival time of pneumoconiosis patients(P<0.05).ConclusionPulmonary tuberculosis may increase the risk of death in patients with pneumoconiosis.Minera

关 键 词：尘肺 肺结核 生存分析 寿命表 生存曲线 

分 类 号：R135.2[医药卫生—劳动卫生]