职业性肺病肺移植后的临床结局与生存情况：一项单中心回顾性队列研究
Clinical outcomes and survival following lung transplantation for work-related lung disease: a single-center retrospective cohort study.
作者信息
Ju Chunrong, Yang Yalan, Lian Qiaoyan, Wang Lulin, Wang Xiaohua, Wei Bing, Huang Danxia, Xu Xin, He Jianxing
机构信息
State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, China.
出版信息
J Occup Med Toxicol. 2023 Feb 13;18(1):2. doi: 10.1186/s12995-023-00368-4.
BACKGROUND
Patients with work-related lung disease (WRLD) are at increased risk of death caused by severe lung tissue damage and fibrosis. This study aimed to assess the clinical outcomes of lung transplantation (LTx) for WRLD and compare the results of LTx between WRLD and idiopathic pulmonary fibrosis (IPF).
METHODS
This single-center retrospective cohort study reviewed the clinical data of patients who underwent LTx for WRLD or IPF at our hospital between January 2015 and December 2021. Cumulative survival rates after LTx were estimated using the Kaplan-Meier method.
RESULTS
The final analysis included 33 cases of WRLD and 91 cases of IPF. The 33 WRLD patients consisted of 19 (57.6%) cases of silicosis, 8 (24.2%) cases of coal workers' pneumoconiosis, 3 (9.09%) cases of asbestosis, and 3 (9.09%) cases of other WRLD. Pneumothorax as an indication for LTx was significantly more common in the WRLD group than in the IPF group (51.5% vs. 2.2%, P < 0.001). There was no significant difference in the 5-year cumulative survival rate between the WRLD patients and the IPF patients (66.6% vs. 56.7%, P = 0.67). There was no significant difference in the best performance of exercise capacity and lung function between the two groups at 1 year post-transplant.
CONCLUSIONS
LTx had similar survival outcomes and lung function for WRLD and IPF patients. Pneumothorax was the primary indication for lung transplantation in WRLD.
背景
职业性肺病（WRLD）患者因严重肺组织损伤和纤维化导致死亡的风险增加。本研究旨在评估WRLD患者肺移植（LTx）的临床结局，并比较WRLD患者与特发性肺纤维化（IPF）患者的肺移植结果。
方法
这项单中心回顾性队列研究回顾了2015年1月至2021年12月期间在我院接受WRLD或IPF肺移植患者的临床资料。采用Kaplan-Meier法估计肺移植后的累积生存率。
结果
最终分析纳入33例WRLD患者和91例IPF患者。33例WRLD患者中，矽肺19例（57.6%），煤工尘肺8例（24.2%），石棉肺3例（9.09%），其他WRLD 3例（9.09%）。气胸作为肺移植指征在WRLD组比IPF组更常见（51.5%对2.2%，P<0.001）。WRLD患者和IPF患者的5年累积生存率无显著差异（66.6%对56.7%，P = 0.67）。两组移植后1年运动能力和肺功能的最佳表现无显著差异。
结论
WRLD患者和IPF患者肺移植后的生存结局和肺功能相似。气胸是WRLD患者肺移植的主要指征。
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