江苏省2 567例尘肺病患者死因分析

目的 归纳总结尘肺病患者根本死因，探讨不同死因对尘肺病患者期望寿命的影响，为今后尘肺病防治工作提供参考。方法 回顾性分析2 567例尘肺病患者信息资料，通过Excel 2016和SPSS 19.0软件进行统计分析，结合江苏省尘肺病随访存活患者资料，编制简略寿命表和去死因寿命表。结果 男性患者（91.86%）远多于女性；所属行业以采矿业（59.25%）、制造业、交通运输、仓储和邮政业为主，3者累计占比96.57 %；尘肺病种类以矽肺和煤工尘肺为主，两者累计占比88.98%；诊断期别以尘肺壹期（66.03%）为主。患者多直接死于非尘肺病（67%）；尘肺病、恶性肿瘤、心脑血管疾病、肺部感染是尘肺病患者的主要根本死因；恶性肿瘤和尘肺病是各尘肺期别中均居前列的根本死因，心脑血管疾病是壹期（20.24%）和贰期（17.49 %）尘肺病患者不可忽略的根本死因、肺部感染（13.78%）是叁期患者不可忽略的重要死因；尘肺病、肺部以外恶性肿瘤、心脑血管疾病的累积死亡率近些年增幅较大。35～＜40岁年龄组的尘肺病患者期望寿命约为17.43年，尘肺病、肺部以外恶性肿瘤、心脑血管疾病、肺部感染对尘肺病患者的期望寿命影响较大，去尘肺病、去肺部以外恶性肿瘤、去心脑血管疾病、去肺部感染死因后，尘肺病患者期望寿命分别延长5.26、1.57、1.13和1.09年。结论 在积极治疗尘肺病的同时，还要重视并发症和患者自身慢性疾病的治疗，积极治疗尘肺病、恶性肿瘤、心脑血管疾病和肺部感染后，可延长患者生存时间、改善生活质量。

Analysis of causes of death in 2 567 cases of pneumoconiosis in Jiangsu Province

Objective To summarize the underlying causes of death in pneumoconiosis patients and to explore the effects of different death causes on the life expectancy of pneumoconiosis patients, to provide reference for future pneumoconiosis prevention and treatment. Methods The information data of 2 567 patients with pneumoconiosis were retrospectively analyzed, and statistical analysis was carried out by using Excel 2016 and SPSS19.0 software, combined with the data of follow-up surviving patients with pneumoconiosis in Jiangsu Province, to compile abbreviated life table and life-to-death life table. Results There were more male patients (91.86%) than female, and the industries they belonged to were mainly mining (59.25%), manufacturing, and transportation, storage and postal industries, with a cumulative percentage of 96.57%. The types of pneumoconiosis were mainly silicosis and coal workers’ pneumoconiosis, with a cumulative percentage of 88.98% for both. The diagnostic stage was mainly pneumoconiosis stage I (66.03%). Patients mostly died directly from non-pneumoconiosis (67%).Pneumoconiosis, malignant neoplasm, cardiovascular disease, and pulmonary infection were the main underlying causes of death in pneumoconiosis patients; malignant neoplasm and pneumoconiosis were the leading underlying causes of death in all pneumoconiosis stages, cardiovascular disease was a non-negligible underlying cause of death in stage I (20.24%) and stage II (17.49%) pneumoconiosis patients, and pulmonary infection (13.78%) was a non-negligible underlying cause of death in stage III patients. The cumulative mortality rate of pneumoconiosis, malignant neoplasm other than lung, and cardiovascular disease increased significantly in recent years. The life expectancy of pneumoconiosis patients in the age group of 35-34 years was about 17.43 years. The life expectancy of pneumoconiosis patients was prolonged by 5.26 years, 1.57 years, 1.13 years and 1.09 years respectively after removing the malignant tumor outside the lungs, removing the cardiovascular and cerebrovascular diseases, and removing the cause of death from pulmonary infection. Conclusion While actively treating pneumoconiosis, we should also pay attention to the treatment of complications and patients’ own chronic diseases. After actively treating pneumoconiosis, malignant tumors, cardiovascular and cerebrovascular diseases and pulmonary infections, patients’ survival time and quality of life can be prolonged and improved.