无锡市矽肺患者生存分析

Survival analysis of silicosis patients in Wuxi City

目的通过研究分析1975至2019年无锡市矽肺患者生存状况及其影响因素。方法于2019年8月1日至2019年12月31日,通过无锡市居民死因监测、历年诊断纸质材料与网报系统,并结合公安与人社系统获得3721例矽肺患者为研究对象,采用Kaplan-Meier法与寿命表法结合,进行单因素生存分析,通过Cox回归模型分析影响患者生存时间的因素。结果无锡市1975至2019年共报告矽肺3721例,死亡1274例,病死率34.24%,中位生存时间30.9年。随着诊断时间的推移,矽肺患者病死率呈明显下降趋势(χ^(2)=747.75,P<0.05)。与壹期矽肺患者比较,叁期矽肺患者生存时间减少的风险增加(HR=1.486,P<0.05);与不吸烟患者比较,吸烟患者生存时间减少的风险增加(HR=1.136,P<0.05)。与发病年龄<30岁比较,发病年龄40~49岁、50~59岁、≥60岁患者生存时间减少的风险增加(HR=9.641、13.650、26.794,P<0.05);与工伤保险保障患者比较,用人单位赔付、城乡居民基本医疗保险、其他保障、无保障的患者生存时间减少风险增加(HR=3.137、3.119、5.129、8.442,P<0.05)。结论矽肺患者的生存时间与矽肺期别、吸烟情况、发病年龄和保障情况均相关。应重点关注并控制上述风险因素,从而提高患者生活质量,延长其生命。

Objective To analyze the living condition and influencing factors of silicosis patients in Wuxi City form 1975 to 2019.Methods Through the monitoring of death causes of residents,the paper-based materials and online report system of diagnosis over the years,and the combination of public security and human social system to obtain 3721 cases of silicosis patients as subjects form August to December 2019.And the combination of Kaplan Meier method and life table method were used to carry out single factor survival analysis.Through Cox regression model to analyze the factors affecting the survival time of patients.Results From 1975 to 2019,3721 cases of silicosis and 1274 deaths have been reported in Wuxi City,with a mortality rate of 34.24%and a median survival time of 30.9 years.With the development of diagnosis time,the mortality decreased significantly(χ^(2)=747.75,P<0.05).Compared with the first stage silicosis patients,the risk of decreased survival time of the third stage silicosis patients increased(HR=1.486,P<0.05).Compared with the non-smoking patients,the risk of decreased survival time of the smoking patients increased(HR=1.136,P<0.05).Compared with the patients who were less than 30 years old,the risk of decreased survival time of patients with 40-49 years old,50-59 years old and more than 60 years old were increased(HR=9.641,13.650,26.794,P<0.05).Compared with the patients who received industrial and commercial insurance,the risk of decreased survival time of patients who received compensation from employers,basic medical insurance for urban and rural residents,other social compensation and no compensation were increased(HR=3.137,3.119,5.129,8.442,P<0.05).Conclusion The survival time of silicosis patients is related to the stage of silicosis,smoking condition,age of onset and social compensation.We should focus on controlling the above risk factors so as to improve the quality of life of patients and prolong their lives.