中国煤矿工人北戴河疗养院入院治疗的165例矽肺患者矽肺进展危险因素分析

Analysis on risk factors of silicosis progress from 165 hospitalized patients in China's Coal Miners Beidaihe Sanatorium

目的收集165例矽肺患者基本情况、职业暴露史、矽肺对健康影响等资料,寻找矽肺进展的危险因素。方法收集2016年10月16日—2017年4月16日入院的165名矽肺患者相关资料,对可能影响矽肺进展的17个因素进行χ~2检验;将χ~2检验后有差异的因素纳入回归方程进行有序logistic回归分析。结果我们共收集165例矽肺患者相关资料,肺内粉尘沉着症22例,一期矽肺42例,二期矽肺36例,三期矽肺65例。年龄、民族、运动情况、学历、血型、体质指数、地区、接尘时间、脱尘时间、合并脂肪肝、合并肾结石、合并肺结核、合并心脑血管情况共13个因素在不同矽肺期别间比较,差异无统计学意义(P>0.05),吸烟史、饮酒史、矽肺患者吸入粉尘的性质、是否合并慢性阻塞性肺疾病(COPD)共4个因素在不同期别矽肺间比较,差异有统计学意义(P<0.05),很可能是矽肺进展的危险因素。将吸烟史、饮酒史、矽肺患者吸入粉尘的性质、是否合并COPD 4个因素纳入回归方程进行有序logistic回归分析,最终保留是否有饮酒史、吸入粉尘性质、是否合并COPD3个变量。结论经统计学分析,是否有饮酒史、吸入粉尘性质、是否合并COPD 3个因素可能是矽肺进展的危险因素。

[Objective] To collect the data of basic situation, occupational exposure and health effects from silicosis from165 silicosis patients, find the risk factors of silicosis progress. [Methods] The relevant information of 165 silicosis patients who were treated from October 16, 2016 to April 16, 2017 in the hospital was collected. 17 factors that maybe impact on the progress of silicosis were analyzed by χ~2 test, and factors with significant difference were analyzed by ordinal logistic regression analysis.[Results] Totally 165 cases were investigated, including 22 cases of dust deposition in the lungs, 42 cases of phaseⅠsilicosis,36 cases of phase Ⅱsilicosis and 65 cases of phase Ⅲ silicosis. For 13 factors, including age, nationality, exercise, education background, blood group, body mass index, region, dust exposure duration, dust removal time, fatty liver, kidney stone,Pulmonary tuberculosis, cardiovascular and cerebrovascular diseases, there were no statistically significant differences among different silicosis phases（P 〉0.05）. 4 factors of smoking history, drinking history, nature of the dust and chronic obstructive pulmonary disease（COPD） showed the statistically significant differences among different silicosis phases（P〈0.05）, which might be the risk factors for silicosis progress. These 4 factors were analyzed by the regression equation, and the ordinal logistic regression analysis remained three variables of history of alcohol, nature of the dust and COPD. [Conclusion] Through statistical analysis, history of alcohol, nature of the dust and COPD are the possible risk factors for silicosis progress.