尘肺患者合并COPD的相关危险因素分析

Analysis of risk factors for pneumoconiosis patients complicated with COPD

目的分析并探讨尘肺病患者合并慢性阻塞性肺疾病(COPD)的相关危险因素及其预防措施。方法选择2019年8月—2020年1月在中国煤矿工人北戴河疗养院尘肺科入院治疗的193例尘肺病患者进行病例对照研究,根据尘肺患者是否合并COPD分为病例组和对照组,采用调查问卷与临床病历资料收集相结合的方式进行调查,并对病例组与对照组的统计资料进行统计学分析。结果本次研究对象均为男性,其中病例组83人,对照组110人,尘肺患者合并COPD的合并率为43.01%。单因素分析结果显示,病例组与对照组患者在体质指数(BMI)、接尘时间、外周血中性粒细胞-淋巴细胞比值(NLR)、血小板-淋巴细胞比值(PLR)、C反应蛋白(CRP)浓度、民族、户籍、是否吸烟、住房类型、尘肺期别及体力活动水平因素上差异均有统计学意义(均P<0.05)。多因素logistic回归分析显示,中高强度体力活动是尘肺患者合并COPD的保护因素(P<0.01),尘肺期别、CRP均是尘肺患者合并COPD的危险因素(均P<0.01)。结论体力活动水平是影响尘肺患者合并COPD的独立保护因素,尘肺期别及CRP是影响尘肺患者合并COPD的独立危险因素,应加强安全培训和采取防护措施,定期进行职业健康检查,改变生活方式,提升患者的健康生活质量。

Objective To investigate the related risk factors of pneumoconiosis patients complicated with chronic obstructive pulmonary disease(COPD),explore the preventive measure. Methods Totally 193 pneumoconiosis patients who were treated in the Department of Pneumoconiosis of Beidaihe Sanatorium for Coal Miners of PRC from August 2019 to January 2020 were collected for the case-control study,and were divided into the case group and the control group according to whether pneumoconiosis patients were complicated with COPD. The combination of questionnaire and clinical medical records collection was adopted for the survey. The data of the case group and the control group were analyzed statistically. Results All the subjects were male,including 83 patients in the case group and 110 in the control group. The combined rate of COPD in pneumoconiosis patients was 43.01%. Univariate analysis showed that there were statistically significant differences in body mass index(BMI),dust exposure time,peripheral blood neutrophil-lymphocyte ratio(NLR),platelet-lymphocyte ratio(PLR),C-reactive protein(CRP),nationality,household registration,smoking,housing type,pneumoconiosis stage and physical activity level between the case group and the control group(all P<0.05). Multivariate logistic regression analysis showed that moderate and high-intensity physical activity was a protective factor for pneumoconiosis patients with COPD(P<0.01),while pneumoconiosis stage and CRP were risk factors(both P <0.01). Conclusion Physical activity level is an independent protective factor that affects pneumoconiosis patients with COPD,while pneumoconiosis stage and CRP are independent risk factors that affect pneumoconiosis patients with COPD. Safety training and protective measures should be strengthened,occupational health examination should be carried out regularly,unhealthy lifestyle should be changed,and improve the healthy life quality of patients.