问卷筛查与肺功能检测在粉尘作业农民工中的应用

Analysis of chronic obstructive pulmonary disease screening questionnaire and pulmonary function test among migrant workers exposed to dust

目的分析慢性阻塞性肺疾病(COPD)筛查问卷与肺功能检测在粉尘作业农民工中筛查COPD的应用情况。方法于2019年5月,通过湖南省职业病防治院下乡义诊选取149例粉尘作业农民工作为研究对象,进行COPD问卷筛查与肺功能检测,分析其筛查出高危人群情况及肺功能检查结果阳性的影响因素。结果149例粉尘作业农民工中,问卷筛查结果阳性107人(71.8%),肺功能检查结果阳性73人(49.0%),最终诊断煤工尘肺75人(50.3%),有肺功能损伤者101人(67.8%)。筛查问卷结果阳性粉尘作业农民工肺功能结果阳性率明显高于筛查问卷结果阴性者,差异有统计学意义(P<0.05)。多因素分析结果显示,与无尘肺病者比较,叁期尘肺病粉尘作业农民工肺功能检查结果阳性的风险增高(OR=16.462,95%CI:3.390~79.946;P<0.01);与不吸烟者比较,吸烟指数11~20包年和>20包年的粉尘作业农民工肺功能检查结果阳性的风险增高(OR=19.814,95%CI:3.854~101.883;OR=9.733,95%CI:2.310~41.008;P<0.01)。结论粉尘作业农民工COPD患病风险较高,应加强对尘肺病期别高和吸烟人群的早期检查,筛查问卷可较好地筛查出COPD高危人群,作为基层筛查工具推广应用。

Objective To analyze the application of Chronic Obstructive Pulmonary Disease(COPD)Screening Questionnaire and pulmonary function test in dust-exposed migrant workers.Methods In May 2019,149 cases of dust exposed migrant workers were selected as the research subjects through the free clinic in the countryside.COPD Screening Questionnaire and lung function test were carried out to analyze the high-risk groups and the influencing factors of positive pulmonary function test results.Results Among 149 cases of dust-exposed migrant workers,107(71.8%)were positive for questionnaire screening,73(49.0%)were positive for pulmonary function test,75(50.3%)were diagnosed with coal worker's pneumoconiosis,and 101(67.8%)were diagnosed with lung function injury.The positive rate of pulmonary function of migrant workers with positive questionnaire screening results was significantly higher than that of those with negative results(P<0.05).The results of multivariate analysis showed that compared with non-pneumoconiosis,the risk of positive pulmonary function test results was higher in dust-exposed migrant workers with stageⅢpneumoconiosis(OR=16.462,95%CI:3.390-79.946;P<0.01).Compared with non-smoking,the risks of positive pulmonary function test results of dust-exposed migrant workers with smoking index of 11-20 package years and>20 package years were higher(OR=19.814,95%CI:3.854-101.883;OR=9.733,95%CI:2.310-41.008;P<0.01).Conclusion The risk of COPD in dust-exposed migrant workers is high,so we should strengthen the early examination of the high pneumoconiosis stage and smoking population.The screening questionnaire can better screen out the high-risk groups of COPD,and it can be used as a basic screening tool.