2019—2023年浙江省宁海县尘肺病患者的生存分析

Survival analysis of pneumoconiosis patients in Ninghai County of Zhejiang Province,2019‒2023

【目的】了解2019—2023年随访的浙江省宁海县尘肺病患者生存时间及可能影响因素,为延长尘肺患者生存期提供参考。【方法】从职业病及健康危害因素监测信息系统的子模块职业病随访管理和随访Excel数据库获取尘肺病患者相关信息,采用Kaplan‑Meier生存曲线和Cox回归模型进行生存分析。【结果】366例尘肺病患者中男性占99.73%,壹期尘肺占71.04%,病种以矽肺为主。患尘肺病后5、10和20年的生存率分别为97%、88%和62%,累积生存率为42%。尘肺病患者中位生存时间为32.11年。Log‑rank检验发现,不同尘肺病期别、首诊年龄、尘肺病并发症的患者生存曲线差异有统计学意义。Cox回归分析发现,尘肺叁期患者生存时间减少的风险是壹期的2.184倍(P=0.007)。首诊年龄为50~岁与≥60岁的2组患者生存时间减少的风险是<50岁患者组的3.457倍与7.097倍(均P<0.001)。尘肺病并发症患者的生存时间减少风险是无并发症患者的2.030倍(P=0.003)。【结论】宁海县尘肺患者的生存时间受到首诊年龄、尘肺病分期和尘肺病并发症的影响。通过及时发现和诊断,以及积极防治尘肺病并发症,可以延长患者的生存期。

[Objective]To understand the survival time and possible influencing factors of pneumoconiosis patients in Ninghai County,Zhejiang Province who were followed up from 2019 to 2023,and to provide references for prolonging the survival time of pneumoconiosis patients.[Methods]Information about pneumoconiosis patients was collected from the sub-module Occupational Disease Follow-Up Management and Follow-Up Excel database of the Occupational Disease and Health Hazards Monitoring Information System.Survival analysis was conducted through applying Kaplan-Meier survival curves and Cox regression models.[Results]Of the 366 pneumoconiosis patients,99.73%were male,71.04%had stageⅠpneumoconiosis,and the disease type was mainly silicosis.The survival rates at 5,10,and 20 years after diagnosis of pneumoconiosis were 97%,88%,and 62%,respectively,with a cumulative survival rate of 42%.The median survival time of patients with pneumoconiosis was 32.11 years.Log-rank test found statistically significant differences in the survival curves among pneumoconiosis patients with different pneumoconiosis stages,age at first diagnosis,and pneumoconiosis complications.Cox regression analysis revealed that the risk of reduced survival time in patients with pneumoconiosis stageⅢwas 2.184 times higher than that of patients with stageⅠ(P=0.007).In comparison with the age of first diagnosis at<50 years old group,the risk of reduced survival time was 3.457 and 7.097 times higher,respectively,in the groups of patients who received the diagnosis at 50‒and≥60 years(both P<0.001).The risk of reduced survival time in pneumoconiosis patients with complications was 2.030 times higher than that of patients without complications(P=0.003).[Conclusion]Survival time of pneumoconiosis patients in Ninghai County is affected by the age at first diagnosis,pneumoconiosis stage and pneumoconiosis complications.The survival time can be significantly prolonged by timely detection and diagnosis,as well as active prevention and treatment of pneumoconiosis complications.