Chuang Chieh-Sen, Ho Shang-Chang, Lin Cheng-Li, Lin Ming-Chia, Kao Chia-Hung
From the Department of Neurology, Changhua Christian Hospital, Changhua (C-SC, S-CH); Department of Life Sciences, National Chung-Hsing University (C-SC); College of Medicine, China Medical University (C-LL); Management Office for Health Data, China Medical University Hospital, Taichung (C-LL); Department of Nuclear Medicine, E-Da Hospital, I-Shou University, Kaohsiung (M-CL); Department of Nuclear Medicine and PET Center, China Medical University Hospital (C-HK); and Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University (C-HK), Taichung, Taiwan.
Medicine (Baltimore). 2016 Mar;95(9):e2944. doi: 10.1097/MD.0000000000002944.
Pneumoconiosis is a parenchymal lung disease that develops through the inhalation of inorganic dust at work. Cerebrovascular and cardiovascular events are leading causes of mortality and adult disability worldwide. This retrospective cohort study investigated the association between pneumoconiosis, and cerebrovascular and cardiovascular events by using a nationwide population-based database in Taiwan. The data analyzed in this study was retrieved from the Taiwan National Health Insurance Research Database. We selected 6940 patients with pneumoconiosis from the database as our study cohort. Another 27,760 patients without pneumoconiosis were selected and matched with those with pneumoconiosis according to age and sex as the comparison cohort. We used univariate and multivariate Cox proportional-hazard regression analyses to determine the association between pneumoconiosis and the risk of cerebrovascular and cardiovascular events after adjusting for medical comorbidities. After adjustment for age, sex, and comorbidities, the patients with pneumoconiosis exhibited a significantly higher incidence of ischemic stroke (hazard ratio [HR] 1.14, 95% confidence interval [CI] 1.05-1.24) than did those without pneumoconiosis. The incidence of hemorrhagic stroke was higher, but not significant, in the pneumoconiosis patients (HR 1.20, 95% CI 0.99-1.46). No statistically significant differences were observed between the pneumoconiosis and nonpneumoconiosis groups in acute coronary syndrome (HR 1.10, 95% CI 0.95-1.26). The findings of this study reveal an association between pneumoconiosis and a higher risk of cerebrovascular events after adjustment for comorbidities. Healthcare providers should control the related risk factors for primary prevention of stroke in pneumoconiosis patients.
尘肺病是一种因工作中吸入无机粉尘而引发的实质性肺部疾病。脑血管和心血管事件是全球范围内导致死亡和成人残疾的主要原因。这项回顾性队列研究利用台湾全国性的基于人群的数据库,调查了尘肺病与脑血管和心血管事件之间的关联。本研究分析的数据取自台湾国民健康保险研究数据库。我们从数据库中选取了6940例尘肺病患者作为研究队列。另外选取了27,760例无尘肺病患者,并根据年龄和性别与尘肺病患者进行匹配作为对照队列。我们使用单因素和多因素Cox比例风险回归分析,在调整医疗合并症后确定尘肺病与脑血管和心血管事件风险之间的关联。在调整年龄、性别和合并症后,尘肺病患者发生缺血性卒中的发生率显著高于无尘肺病患者(风险比[HR] 1.14,95%置信区间[CI] 1.05 - 1.24)。尘肺病患者出血性卒中的发生率较高,但无统计学意义(HR 1.20,95% CI 0.99 - 1.46)。在急性冠状动脉综合征方面,尘肺病组和非尘肺病组之间未观察到统计学显著差异(HR 1.10,95% CI 0.95 - 1.26)。本研究结果揭示了在调整合并症后,尘肺病与脑血管事件的较高风险之间存在关联。医疗保健提供者应控制相关风险因素,以对尘肺病患者进行中风的一级预防。