Chen Qing, Zhang Peng, Chen Xuxi, Zou Yanqiu, Liao Jiaqiang, Zhang Qin, Peng Lijun, Lan Yajia, Yao Yuqin, He Qiurong
/ ( 610041) Department of Occupational and Environmental Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610041, China.
( 610041) West China Occupational Pneumoconiosis Cohort Study (WCOPCS) Work Group, Chengdu 610041, China.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2024 Jan 20;55(1):167-175. doi: 10.12182/20240160107.
To explore the risk factors for developing chronic pulmonary heart disease in patients with pneumoconiosis.
The medical records of pneumoconiosis patients admitted to an occupational disease hospital in Sichuan Province between January 2012 and November 2021 were collected. Kaplan-Meier (K-M) method, or product-limit method, was used to plot the incidence curves of pulmonary heart disease in the pneumoconiosis patients. Cox proportional hazard regression model was used to analyze the influencing factors associated with chronic pulmonary heart disease in patients with pneumoconiosis.
A total of 885 pneumoconiosis patients were included in this study. The follow-up time was 12 to 115 months and the median follow-up time was 43 months. A total of 138 patients developed chronic pulmonary heart disease and the incidence density of pulmonary heart disease was 38.50/1000 person-years. Multivariate Cox proportional hazard regression analysis showed that the influencing factors of pneumoconiosis inpatients developing chronic pulmonary heart disease included the following, being 50 and older (hazard ratio []=1.85, 95% confidence interval []: 1.25-2.74), stage Ⅲ pneumoconiosis (=2.43, 95% : 1.48-4.01), resting heart rate≥100 beats/min (=2.62, 95% : 1.63-4.21), the complication of chronic obstructive pulmonary disease (COPD) (=4.52, 95% : 2.12-9.63), underweight (=2.40, 95% : 1.48-3.87), overweight and obesity (=0.54, 95% : 0.34-0.86), and triacylglycerol (TG) (=0.69, 95% : 0.49-0.99).
Old age, stage Ⅲ pneumoconiosis, high resting heart rate, low BMI, and the complication of COPD are risk factors for chronic pulmonary heart disease in pneumoconiosis patients, while overweight and obesity and TG are protective factors. Early identification of the risk factors and the adoption of the corresponding prevention measures are the key to preventing chronic pulmonary heart disease in patients with pneumoconiosis.
探讨尘肺病患者发生慢性肺源性心脏病的危险因素。
收集2012年1月至2021年11月四川省某职业病医院收治的尘肺病患者的病历资料。采用Kaplan-Meier(K-M)法即乘积极限法绘制尘肺病患者肺心病的发病曲线。采用Cox比例风险回归模型分析尘肺病患者慢性肺源性心脏病的相关影响因素。
本研究共纳入885例尘肺病患者。随访时间为12至115个月,中位随访时间为43个月。共有138例患者发生慢性肺源性心脏病,肺心病的发病密度为38.50/1000人年。多因素Cox比例风险回归分析显示,尘肺病住院患者发生慢性肺源性心脏病的影响因素如下:年龄50岁及以上(风险比[]=1.85,95%置信区间[]:1.25-2.74)、Ⅲ期尘肺病(=2.43,95%:1.48-4.01)、静息心率≥100次/分钟(=2.62,95%:1.63-4.21)、慢性阻塞性肺疾病(COPD)并发症(=4.52,95%:2.12-9.63)、体重过轻(=2.40,95%:1.48-3.87)、超重和肥胖(=0.54,95%:0.34-0.86)以及甘油三酯(TG)(=0.69,95%:0.49-0.99)。
高龄、Ⅲ期尘肺病、静息心率高、低体重指数以及COPD并发症是尘肺病患者发生慢性肺源性心脏病的危险因素,而超重和肥胖以及TG是保护因素。早期识别危险因素并采取相应的预防措施是预防尘肺病患者慢性肺源性心脏病的关键。