螺旋计限制与类药物死亡率的关联:一个队列研究
Shuyuan Yang1, Chi Kuen Chan2, Maggie Haitian Wang1
1Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China.
BMC pulmonary medicine
|September 4, 2023
概括
限制性螺旋测量模式 (RSP) 显著增加了病患者的死亡风险. 混合的限制性和阻碍性模式带来了最高的死亡风险,强调了在职业环境中早期检测的必要性.
科学领域:
- 肺部医学 肺部医学
- 职业健康 职业健康 职业健康
- 流行病学 流行病学
背景情况:
- 限制性螺旋测量模式 (RSP),以减少强迫生命能力 (FVC) 而没有空气流阻塞 (AFO) 为特征,与一般人群中较高的死亡率有关.
- 关于RSP对死亡率的影响的证据有限,特别是在病患者队列中.
研究的目的:
- 调查限制性螺旋测量模式 (RSP) 与被诊断患有病的患者因任何原因和呼吸相关死亡的风险之间的关联.
- 为了比较血病患者的死亡风险,正常的螺旋计,分离的RSP,分离的AFO,混合的RSP和AFO.
主要方法:
- 一项回顾性队列研究,涉及4315名在1981-2019年间被诊断出患有病的患者 (18-80岁),随访时间为2019年12月.
- 螺旋测量数据被用来将肺功能分为正常,只有RSP,只有AFO和混合RSP和AFO类别.
- 考克斯的比例危险模型被用来计算危险比率 (HR) 和95%置信区间 (95% CI),调整了诸如年龄,BMI,肺结核病史,吸烟状况和放射性特征等共变量.
主要成果:
- 在病患者中RSP的患病率为24.1% (11.0%仅RSP,13.1%混合RSP和AFO).
- 与正常螺旋计相比,只有RSP的病患者的全因死亡率 (HR=1.63) 和呼吸相关死亡率 (HR=1.56) 的风险显著增加.
- 与仅有RSP的患者相比,患有混合RSP和AFO的患者对所有原因 (HR=2.22) 和呼吸相关死亡率 (HR=2.59) 的风险明显更高.
结论:
- 限制性螺旋测量模式 (RSP) 是一个显著的独立预测器,可预测症患者的全因和呼吸相关死亡率的增加.
- 限制性和阻塞性呼吸系统缺陷在病患者的同时发生,与单独的RSP或AFO相比,死亡风险明显增加.
- 这些发现强调了识别和管理RSP,特别是混合呼吸系统缺陷,在病患者的职业健康监测中至关重要.
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