Yen Chia-Ming, Lin Cheng-Li, Lin Ming-Chia, Chen Huei-Yong, Lu Nan-Han, Kao Chia-Hung
Department of Anesthesiology, Buddhist Tzu Chi General Hospital, Taichung Branch Management Office for Health Data, China Medical University Hospital College of Medicine, China Medical University, Taichung Department of Nuclear Medicine, E-DA Hospital, I-Shou University, Kaohsiung Department of Radiology, E-DA Hospital, I-Shou University, Kaohsiung Department of Nuclear Medicine PET Center, China Medical University Hospital Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.
Medicine (Baltimore). 2016 Jun;95(25):e3972. doi: 10.1097/MD.0000000000003972.
The purpose of the study was to determine the relationship between pneumoconiosis and congestive heart failure (CHF).We collected data from the National Health Insurance Research Database in Taiwan. The study sample comprised 8923 patients with pneumoconiosis and 35,692 nonpneumoconiosis controls enrolled from 2000 to 2011. Patients were followed up until the end of 2011 to evaluate the incidence of CHF. The risk of CHF was analyzed using Cox proportional hazard regression models, and the analysis accounted for factors such as sex, age, comorbidities, and air pollutants (μg/m).The overall incidence of CHF was higher in the pneumoconiosis cohort (15.7 per 1000 person-y) than in the nonpneumoconiosis cohort (11.2 per 1000 person-y), with a crude hazard ratio (HR) of 1.40 (P < 0.001). The HR for CHF was 1.38-fold greater in the pneumoconiosis cohort than in the nonpneumoconiosis cohort (P < 0.001) after the model was adjusted for age, sex, various comorbidities, and air pollutants (μg/m). The relative risk for CHF in the sex-specific pneumoconiosis cohort compared with the nonpneumoconiosis cohort was significant for men (adjusted HR = 1.40, 95% confidence interval = 1.21-1.62, P < 0.001). The incidence density rates of CHF increased with age; pneumoconiosis patients had a higher relative risk of CHF for all age group.Patients with pneumoconiosis were at higher risk for developing CHF than patients in the nonpneumoconiosis cohort, particularly in cases with coexisting coronary artery disease, hypertension, and chronic obstructive pulmonary disease.
本研究的目的是确定尘肺病与充血性心力衰竭(CHF)之间的关系。我们从台湾国民健康保险研究数据库收集数据。研究样本包括2000年至2011年登记的8923例尘肺病患者和35692例非尘肺病对照。对患者进行随访至2011年底,以评估CHF的发病率。使用Cox比例风险回归模型分析CHF的风险,并对性别、年龄、合并症和空气污染物(μg/m)等因素进行分析。尘肺病队列中CHF的总体发病率(每1000人年15.7例)高于非尘肺病队列(每1000人年11.2例),粗风险比(HR)为1.40(P<0.001)。在对年龄、性别、各种合并症和空气污染物(μg/m)进行模型调整后,尘肺病队列中CHF的HR比非尘肺病队列高1.38倍(P<0.001)。与非尘肺病队列相比,特定性别的尘肺病队列中男性CHF的相对风险显著(调整后HR=1.40,95%置信区间=1.21-1.62,P<0.001)。CHF的发病密度率随年龄增加而升高;尘肺病患者在所有年龄组中患CHF的相对风险更高。与非尘肺病队列中的患者相比,尘肺病患者发生CHF的风险更高,尤其是在同时患有冠状动脉疾病、高血压和慢性阻塞性肺疾病的情况下。