尘肺合并慢性阻塞性肺疾病患病率及危险因素的meta分析

职业与健康 ›› 2023, Vol. 39 ›› Issue (14): 2003-2008.

尘肺合并慢性阻塞性肺疾病患病率及危险因素的meta分析

任源¹, 王一如¹, 张新日², 孔晓梅², 庞敏²

1.山西医科大学第一临床医学院,山西太原 030001;
2.国家卫生健康委尘肺病重点实验室,呼吸疾病防治与基础研究山西省重点实验室,山西医科大学第一医院呼吸与危重症医学科,山西太原 030001

收稿日期:2022-10-27 修回日期:2022-11-21 出版日期:2023-07-15 发布日期:2026-03-24
通信作者: 庞敏,教授,E-mail：pangmin2009@126.com
作者简介:任源,女,在读硕士研究生,研究方向为劳动卫生与呼吸系统疾病。
基金资助:
煤工尘肺专病队列研究及早期筛查策略的建立（2020-PT320-005）; 山西省回国留学人员科研资助项目CC16在细胞衰老致COPD发生中的作用及重组CC16干预效果研究（2022-191）

Prevalence and risk factors of chronic obstructive pulmonary disease in patients with pneumoconiosis：A meta-analysis

REN Yuan¹, WANG Yiru¹, ZHANG Xinri², KONG Xiaomei², PANG Min²

1. First Clinical Medical College,Shanxi Medical University,Taiyuan Shanxi,030001,China;
2. National Health Commission Key Laboratory of Pneumoconiosis,Key Laboratory of Prophylaxis and Treatment and Basic Research for Respiratory Diseases of Shanxi Province,Pulmonary and Critical Care Medicine Department of First Hospital of Shanxi Medical University,Taiyuan Shanxi,030001,China

Received:2022-10-27 Revised:2022-11-21 Online:2023-07-15 Published:2026-03-24
Contact: PANG Min,Professor,E-mail：pangmin2009@126.com

摘要/Abstract

摘要： 目的系统评价尘肺合并慢性阻塞性肺疾病（简称慢阻肺）的患病率及危险因素。方法检索PubMed、The Cochrane Library、Web of Science（WOS）、中国生物医学文献数据库、中国知网、万方数据库、维普中文科技期刊全文数据库自建库至2022年7月发表的与尘肺合并慢阻肺患病率及危险因素有关的文献。由2名评价者独立筛选文献、提取数据、纳入文献质量进行评价,采用STATA 16.0进行meta分析。结果共纳入25个研究,包括10 882例研究对象,4 141例尘肺合并慢阻肺患者。Meta分析结果显示,尘肺合并慢阻肺的患病率为41.36%,95%CI=33.41~49.31。年龄（OR=1.83,95%CI=1.28~2.60）、接尘工龄（OR=1.97,95%CI=1.12~3.45）、尘肺期别（OR=2.64,95%CI=2.16~3.23）、吸烟史（OR=1.92,95%CI=1.65~2.23）、吸烟指数（OR=1.98,95%CI=2.12~3.49）、居住环境OR=2.55,95%CI=1.64~3.97）、教育程度（OR=1.42,95%CI=1.04~1.93）、呼吸系统疾病家族史（OR=2.63,95%CI=1.78~3.89）均是尘肺合并慢阻肺的致病危险因素（均P<0.05）。体质量指数（OR=1.63,95%CI=0.86~3.11）与尘肺人群合并慢阻肺的关联差异无统计学意义（P>0.05）。结论尘肺患者的慢阻肺患病率较高,年龄、接尘工龄、尘肺期别、有吸烟史、吸烟指数、居住环境脏乱、文化水平低及有呼吸系统疾病家族史是尘肺合并慢阻肺的危险因素,且尘肺期别这一危险因素与尘肺合并慢阻肺的关联性最强。识别诸多危险因素对于预防尘肺合并慢阻肺的发生有较大帮助。

关键词: 尘肺病, 慢性阻塞性肺疾病, 患病率, 危险因素

Abstract: Objective To systematically evaluate the prevalence and risk factors of pneumoconiosis complicated with chronic obstructive pulmonary disease（COPD）. Methods The literature related to the prevalence and risk factors of pneumoconiosis complicated with COPD was searched in PubMed,Cochrane Library,Web of Sciencee（WOS）,CBM,CNKI,Wanfang Database from the establishment of the library to July 2022. Two researchers screened the literature,extracted valid data and evaluated the quality of the included studies independently. Meta-analysis was carried out using STATA 16.0. Results A total of 25 studies,including 10 882 participants and 4 141 patients with pneumoconiosis complicated with COPD were included.The meta-analysis showed that the prevalence of pneumoconiosis complicated with COPD was 41.36%,95%CI was 33.41%-49.31%. The age（OR=1.83,95%CI=1.28-2.60）,dust-exposure duration（OR=1.97,95%CI=1.12-3.45）,pneumoconiosis stage（OR=2.64,95%CI=2.16-3.23）,smoking history（OR=1.92,95%CI=1.65-2.23）,smoking index（OR=1.98,95%CI=2.12-3.49）,living environment（OR=2.55,95%CI=1.64-3.97）,education level（OR=1.42,95%CI=1.04-1.93） and family history of respiratory diseases（OR=2.63,95%CI=1.78-3.89） were risk factors for pneumoconiosis complicated with COPD. The body mass index（OR=1.63,95%CI=0.86-3.11） was not statistically correlated with pneumoconiosis patients complicated with COPD.Conclusions The prevalence of pneumoconiosis complicated with COPD is high. Age,dust-exposure duration,pneumoconiosis stage,smoking history,smoking index,messy living environment,lower education level,and family history of respiratory diseases are risk factors for pneumoconiosis with COPD,among which the risk factor of pneumoconiosis stage is the strongest association with the occurrence of pneumoconiosis complicated with COPD. Identifying many risk factors is of great help to prevent the occurrence of pneumoconiosis complicated with COPD.

Key words: Pneumoconiosis, Chronic obstructive pulmonary disease, Prevalence, Risk factors, Meta-analysis

中图分类号:

R135.2

任源, 王一如, 张新日, 孔晓梅, 庞敏. 尘肺合并慢性阻塞性肺疾病患病率及危险因素的meta分析. [J]职业与健康, 2023, 39(14): 2003-2008.

REN Yuan, WANG Yiru, ZHANG Xinri, KONG Xiaomei, PANG Min. Prevalence and risk factors of chronic obstructive pulmonary disease in patients with pneumoconiosis：A meta-analysis. [J]OCCUPATION AND HEALTH, 2023, 39(14): 2003-2008.

参考文献

[1] 中华人民共和国国家卫生和计划生育委员会.职业性尘肺病的诊断GBZ 70—2015[S].北京:中国民主法制出版社,2015:1.
[2] Global Initiattvefor Chronic Obstructive Lung Disease.Pocket Guideto Copd Diagnosis,Management,and Evention. A guide for health care professionals.2021 Report[EB/OL].(2020-11-16)[2022-08-18].https://goldcopd.org.
[3] MABILA S L,ALMBERG K S,FRIEDMAN L,et al.Effects of commodity on the risk of emphysema in South African miners[J].Int Arch Occup Environ Health,2020,93(3):315-323.
[4] 曾宪涛,刘慧,陈曦,等.Meta分析系列之四:观察性研究的质量评价工具[J].中国循证心血管医学杂志,2012,4(4):297-299.
[5] 邢景才. 热休克蛋白在煤工尘肺、COPD及肺癌患者表达及其可能作用[D].武汉:华中科技大学,2006.
[6] 王建国,张建芳,王卫,等.煤工尘肺468例罹患慢性阻塞性肺疾病的现况[J].工业卫生与职业病,2007,33(1):46-47.
[7] GIRDLER-BROWN B V,WHITE N W,EHRLICH R I,et al.The burden of silicosis,pulmonary tuberculosis and COPD among former Basotho goldminers[J].Am J Ind Med,2008,51(9):640-647.
[8] 马兰,付小灵.煤工尘肺并发慢性阻塞性肺疾病的影响因素分析[J].中华劳动卫生职业病杂志,2010,28(11):849-850.
[9] 叶绍色. 尘肺合并慢性阻塞性肺疾病的回顾性分析[J].职业与健康,2010,26(7):739-740.
[10] 肖显俊,靳伟,张卓然,等.煤工尘肺合并慢性阻塞性肺疾病的研究分析[J].中国实用医刊,2012(6):20-22.
[11] 林玲,王晶,段晓静.104例矽肺合并症的临床分析[J].中国医学创新,2012,9(24):133-134.
[12] 田君. 200例矽肺合并症的临床分析[J].医学理论与实践,2013,26(11):1454-1455.
[13] 李欣,陈平,陈燕,等.尘肺并发慢性阻塞性肺疾病研究[J].国际呼吸杂志,2013,33(19):1455-1459.
[14] 张秀梅,孙立梅,王文玲.煤工尘肺合并慢性阻塞性肺疾病发病原因及主要应对措施[J].中国实用医药,2013,8(9):49-50.
[15] 李艳红,孙圣华,唐文祥.尘肺合并慢性阻塞性肺疾病患者生存质量研究[J].实用预防医学,2014,21(10):1199-1202.
[16] 余春晓,高鸿,李素文,等.京西地区451例煤工尘肺合并慢性阻塞性肺疾病情况调查[J].中国呼吸与危重监护杂志,2015,14(2):128-131.
[17] 双家兵. 肺尘埃沉着病患者并发慢性阻塞性肺疾病的危险因素分析[J].中国医药导报,2016,13(31):85-88.
[18] 周方联,郑哲,陈恩就,等.尘肺并发慢性阻塞性肺疾病急性加重的相关因素分析[J].中国公共卫生管理,2016,32(4):541-542.
[19] PENG Y,LI X,CAI S,et al.Prevalence and characteristics of COPD among pneumoconiosis patients at an occupational disease prevention institute:A cross-sectional study[J].BMC Pulm Med,2018,18(1):22.
[20] 汪滢,陈红.职业性尘肺病患者并发症的临床治疗分析[J].灾害医学与救援(电子版),2018,7(2):2,4.
[21] 王焕,陈刚,孙志谦,等.中国煤矿工人北戴河疗养院入院治疗的165例矽肺患者矽肺进展危险因素分析[J].职业与健康,2018,34(3):309-312.
[22] 杨静.接尘工龄、年龄与煤工尘肺合并COPD患者的相关性研究[J].中国地方病防治杂志,2018,33(1):112,114.
[23] 李颖,刘贵钱,严薇,等.不同保险类型尘肺病患者的诊断结果及并发症分析[J].中华劳动卫生职业病杂志,2020,38(10):736-738.
[24] FAN Y,XU W,WANG Y,et al.Association of occupational dust exposure with combined chronic obstructive pulmonary disease and pneumoconiosis:A cross-sectional study in China[J].BMJ Open,2020, 10(9):e038874.
[25] 吴佳萍,陆晓玲.尘肺并发慢性阻塞性肺疾病的危险因素分析[J].中华全科医学,2020,18(8):1310-1312.
[26] 张鑫. 煤工尘肺合并慢阻肺高危因素的logistic分析及呼吸训练治疗[J].齐齐哈尔医学院学报,2020,41(6):730-732.
[27] 李欣,戴伟荣,刘文峰,等.428例尘肺病患者3年生存情况分析[J].中国工业医学杂志,2021,34(3):245-246.
[28] 戴伟荣,殷备战,李欣,等.问卷筛查与肺功能检测在粉尘作业农民工中的应用[J].中华劳动卫生职业病杂志,2021,39(8):582-585.
[29] 石蕊. 尘肺患者合并COPD危险因素及其交互作用的病例对照研究[D].唐山:华北理工大学,2021.
[30] 中华人民共和国国家卫生健康委员会. 2021年我国卫生健康事业发展统计公报[EB/OL].(2022-07-12)[2022-08-18].http://www.nhc.gov.cn/guihuaxxs/s3586s/202207/51b55216c2154332a660157abf28b09d.shtml.
[31] WU N,XUE C,YU S,et al.Artificial stone-associated silicosis in China:A prospective comparison with natural stone-associated silicosis[J].Respirology,2020,25(5):518-524.
[32] 赵文莉,李慧,廖萍泰,等.1949—2019年甘肃省职业性尘肺病流行病学特征分析[J].中国工业医学杂志,2021,34(4):345-347.
[33] 袁辉,胡晓远,郝伟,等.2008—2018年新疆煤炭行业职业性尘肺病新发病例分析[J].职业与健康,2022,38(3):289-293.
[34] LONG J,STANSBURY R C,PETSONK E L.Small airways involvement in coal mine dust lung disease[J].Semin Respir Crit Care Med,2015,36(3):358-365.
[35] SCHNEIDER J L,ROWE J H,GARCIA-DE-ALBA C,et al.The aging lung:Physiology,disease,and immunity[J].Cell,2021,184(8):1990-2019.
[36] DENG F,ZHONG S,YU C,et al.Abnormal neutrophil polarization in chronic obstructive pulmonary disease and how cigarette smoke extracts attract neutrophils[J].Ann Transl Med,2022,10(8):472.
[37] RAJU S,KEET C A,PAULIN L M,et al.Rural residence and poverty are independent risk factors for chronic obstructive pulmonary disease in the United States[J].Am J Respir Crit Care Med,2019,199(8):961-969.
[38] 姜潇,丛舒,杨淼,等.中国居民慢性呼吸道症状流行情况及其影响因素分析[J].中华流行病学杂志,2022,43(3):315-323.
[39] 周玉民,王辰,姚婉贞,等.中国七省市慢性阻塞性肺疾病患者的生命质量现况调查[J].中华结核和呼吸杂志,2009,32(4):248-252.