关键词: 慢性阻塞性肺疾病, 煤工尘肺, 急性加重, 危险因素

Abstract:

Objective To investigate the risk factors of re-acute exacerbation of coal workers' pneumoconiosis patients combined with chronic obstructive pulmonary disease（COPD） and further construct clinical prediction model，so as to provide the reference for early detection of high-risk groups of re-acute exacerbation and formulation of targeted prevention and treatment programs. Methods Totally 228 coal workers' pneumoconiosis patients combined with COPD diagnosed and treated in Jincheng General Hospital from January 2020 to June 2023 were retrospectively included and grouped according to whether acute exacerbation occurred again within 12 months after discharge or not. The single factor analysis and multi-factor analysis were used to analyze the independent risk factors of re-acute exacerbation of coal workers' pneumoconiosis patients combined with COPD. The risk prediction model of re-acute exacerbation of coal workers' pneumoconiosis patients combined with COPD was constructed，and the prediction efficiency analysis was performed. Results There were 80 cases with re-acute exacerbation within 12 months after discharge in 228 patients，with the incidence of 35.09%. The results of univariate analysis showed that the course of disease，the number of acute exacerbations in the past 12 months，the score of COPD self-assessment test，and forced vital capacity may be related to the re-acute exacerbation of coal workers' pneumoconiosis with COPD（all P<0.05）. The multivariate Logistic analysis results confirmed that the course of disease ≥10 years，acute exacerbation ≥2 times in the last 12 months，COPD self-assessment test score ≥10 points and lower forced vital capacity were independent risk factors for re-acute exacerbation of coal workers' pneumoconiosis with COPD（all P<0.05）. Using a disease course of ≥ 10 years，a history of ≥2 acute exacerbations within the past 12 months，a COPD self-assessment test score of ≥10 at discharge，forced vital capacity，and a Logistic regression model P-value to predict the probability of recurrent acute exacerbations of coal worker pneumoconiosis with COPD，the receiver operating characteristic（ROC） curve prediction was performed，and the areas under the curves were 0.771，0.724，0.714，0.726 and 0.919，respectively. Conclusions The re-acute exacerbations in coal workers pneumoconiosis patients combined with COPD may be related to the disease course，the number of acute exacerbations in the past 12 months，the score of COPD self-assessment test and forced vital capacity. The data model constructed by using the above four factors has shown good efficacy in predicting the recurrence of acute exacerbations of patients，which is worthy of further analysis in our work.

Key words: Chronic obstructive pulmonary disease, Coal workers' pneumoconiosis, Acute exacerbation, Risk factor