陈仁强, 李文华, 黄静, 于婷. 寿命表法及Cox回归分析608例尘肺病患者发病特征与生存情况[J]. 职业卫生与应急救援, 2021, 39(6): 615-619. DOI: 10.16369/j.oher.issn.1007-1326.2021.06.002
引用本文: 陈仁强, 李文华, 黄静, 于婷. 寿命表法及Cox回归分析608例尘肺病患者发病特征与生存情况[J]. 职业卫生与应急救援, 2021, 39(6): 615-619. DOI: 10.16369/j.oher.issn.1007-1326.2021.06.002
CHEN Renqiang, LI Wenhua, HUANG Jing, YU Ting. Investigation on characteristics of 608 pneumoconiosis patients and their survival by life table method and Cox regression[J]. Occupational Health and Emergency Rescue, 2021, 39(6): 615-619. DOI: 10.16369/j.oher.issn.1007-1326.2021.06.002
Citation: CHEN Renqiang, LI Wenhua, HUANG Jing, YU Ting. Investigation on characteristics of 608 pneumoconiosis patients and their survival by life table method and Cox regression[J]. Occupational Health and Emergency Rescue, 2021, 39(6): 615-619. DOI: 10.16369/j.oher.issn.1007-1326.2021.06.002

寿命表法及Cox回归分析608例尘肺病患者发病特征与生存情况

Investigation on characteristics of 608 pneumoconiosis patients and their survival by life table method and Cox regression

  • 摘要:
      目的  分析菏泽市尘肺病发病特征,探讨接尘工龄与尘肺病发病之间的关系、尘肺病患者死亡趋势和影响生存年限的相关因素。
      方法  对菏泽市1971—2019年诊断的608例尘肺病患者进行调查,采用寿命表法分析接尘工龄与尘肺病的关系、尘肺病病死率及预期存活年限,用Cox比例风险回归模型进行生存分析。
      结果  608例尘肺病患者中壹期575例、贰期24例、叁期9例;年龄主要分布在50 ~ 70岁;工龄主要在10年以内;接尘工种主要为纯掘进工、掘岩工和主掘进工。尘肺病患者发病的接尘工龄为1 ~ 34年;随访时间(x)与累积存活概率(ŷ)的线性回归方程为:ŷ = 1.070 7- 0.037 6 xr = - 0.937 1,P<0.001),尘肺病患者初诊20年后的估计累积存活率为31.87%;理论推算随访时间0 ~ 1年全死因尘肺病患者预期存活年限为11.37年;Cox回归分析结果显示:分别相比壹期、纯掘进工患者,叁期、其他工种患者死亡的风险升至8.590、3.150倍(P < 0.05);相比上一年,本年度接尘的患者死亡的风险降至0.970倍(P < 0.05)。
      结论  提高生活水平和落实各种保障可延长尘肺病患者寿命。在对重点行业、重点岗位和人群加强健康监管的同时,更要重视既往接尘人员的医学随访。

     

    Abstract:
      Objective  To analyze the characteristics of pneumoconiosis in Heze City, and to observe the relationship between dust exposure time and occurrence of pneumoconiosis, the death trend of pneumoconiosis patients and the factors affecting their survival time.
      Methods  A total of 608 patients with pneumoconiosis diagnosed in Heze City from 1971 to 2019 were investigated, pneumoconiosis mortality and expected life span were analyzed by life table method, and the survival was analyzed by Cox case risk regression model.
      Results  Among the 608 patients, 575 cases were diagnosed as pneumoconiosis with stage I, 24 cases with stage Ⅱ and 9 cases with stage Ⅲ. The age was mainly distributed between 50-70 years old and the dust exposure time was mainly less than 10 years. The major jobs were mainly pure tunneling workers, rock diggers and main tunneling workers. The dust exposure time of these pneumoconiosis patients varied from 1 to 34 years. The linear regression equation of follow-up time(x) and cumulative survival probability(ŷ)was: ŷ = 1.070 7 - 0.037 6 x (r = - 0.937 1, P < 0.001), the estimated cumulative survival rate of pneumoconiosis after 20 years of initial diagnosis was 31.87%;the theoretically expected life span of patients with all-cause pneumoconiosis was 11.37 years during follow-up time of 0-1 year. Cox regression analysis results showed that the risk of death of patients with phase Ⅲ was 8.590 times higher than that of patients with phase I, and the rock diggers and main tunneling workers was 3.150 times than pure tunneling workers (P < 0.05). Compared with the cases diagnosed in the previous year, the risk of death of patients diagnosed in this year decreased to 0.970 times(P < 0.05).
      Conclusions  The improvement of living standards and the implementation of various guarantees can prolong the life of pneumoconiosis patients. More attention should be paid to the medical follow-up of previous dust-exposed workers while strengthening the regulation of key industries, key posts and populations.

     

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