【摘要】 目的 通过疾病谱分析大同市煤矿职工与普通人群住院患者的疾病差异情况。方法 选择2023年大同市282 639例住院患者为研究对象，按参保方式分为普通人群组和煤矿职工组，分别有247 897和34 742例。依据《疾病和有关健康问题的国际统计分类第十次修订版》编码统计分析2组人群疾病谱构成情况，对其标准化构成比进行比较。结果 普通人群组、煤矿职工组住院患者均以60～<70岁年龄组患者标准化构成比占比最高（分别占29.02%和33.08%）。2组住院患者循环系统疾病标准化构成比均居首位，煤矿职工组住院患者标准化构成比居前6位疾病中的肿瘤（C00-D48编码），症状、体征和临床与实验室异常所见，不可归类在他处者（R00-R99编码，以下简称“不可归类他处者”），影响健康状况和与保健机构接触的因素（Z00-Z99编码）这3类疾病的标准化构成比均高于普通人群组（11.82%vs10.44%,12.99%vs 8.03%,6.17%vs 2.04%）。2组男性患者循环系统疾病、呼吸系统疾病、消化系统疾病标准化构成比均高于女性（煤矿职工组：19.53%vs 14.31%,13.56%vs 9.10%,10.61%vs 8.43%；普通人群组：26.15%vs 22.42%,15.45%vs11.87%,11.52%vs 10.41%），女性不可归类他处者、影响健康状况和与保健机构接触的因素疾病标准化构成比均高于男性（煤矿职工组：13.31%vs 12.68%,7.26%vs 5.13%；普通人群组：8.91%vs 7.18%,2.35%vs 1.74%）。精神和行为障碍疾病（F00-F99编码）在普通人群组22～<50岁年龄段高发（9.92%），在煤矿职工组人群50～<60岁年龄段高发（8.58%）。普通人群组、煤矿职工组住院患者呼吸系统疾病标准化构成比在≥80岁年龄段均居于首位（29.54%,26.46%）。2组人群中，男性患者肿瘤首位均是未特指的支气管或肺恶性肿瘤（3.44%,3.62%）；煤矿职工组女性患者未特指的乳房恶性肿瘤标准化构成比高于普通人群组女性患者（2.60%vs 2.09%）。结论 应将肿瘤、异常症状、心理健康纳入煤矿职工重点预防疾病，关注精神疾病年轻群体筛查，并针对男性、女性人群高发肿瘤优化医疗资源配置。更多还原

【Abstract】 Objective To analyze the difference of diseases between the coal mine workers and the general population inpatients by the disease spectrum in Datong City. Methods A total of 282 639 hospitalized patients in Datong City in 2023 were included as the study subjects. Participants were divided into a general population group and a coal mine workers group based on health insurance types, with 247 897 and 34 742 cases, respectively. The disease spectrum of participants in both groups was coded and analyzed according to the International Statistical Classification of Diseases and Related Health Problems, 10 th Revision(ICD-10). The standardized constituent ratios of disease categories were calculated and compared between the two groups. Results Patients aged 60-<70 years had the largest standardized proportion in both cohorts(29.02% in the general population group and 33.08% in coal mine workers group). Circulatory system diseases had the highest standardized proportion in both groups. Within the top six disease categories ranked by standardized composition ratio in the coal mine workers, three demonstrated a higher burden, including neoplasms(C00-D48), symptoms, signs and abnormal clinical/laboratory findings not elsewhere classified(R00-R99), and factors influencing health status/contact with health services(Z00-Z99), compared with the general population(11.82% vs 10.44%, 12.99% vs 8.03%, and 6.17% vs 2.04%, respectively). In both groups, male workers had higher standardized constituent ratios of circulatory, respiratory, and digestive system diseases than females(coal mine workers group, 19.53% vs 14.31%, 13.56% vs 9.10%, 10.61% vs 8.43%; general population group, 26.15% vs 22.42%, 15.45% vs 11.87%, 11.52% vs 10.41%). Conversely, the ratios for conditions classified under symptoms, signs and abnormal clinical/laboratory findings not elsewhere classified(R00-R99). and factors influencing health status/contact with health services(Z00-Z99) were higher in females than males(coal mine workers group, 13.31% vs 12.68%, 7.26% vs 5.13%; general population group, 8.91% vs 7.18%, 2.35% vs 1.74%). Mental and behavioral disorders(F00-F99) were most prevalent in the 22-<50-year age group in the general population(9.92%) and in the 50-<60-year age group in coal mine workers(8.58%). The standardized proportion of respiratory system diseases ranked first in≥80-year age workers in general population group and coal mine workers group(29.54% and 26.46%, respectively). Regarding specific malignancies, unspecified malignant neoplasm of the bronchus or lung was the most common cancer among males in both groups(3.44% and 3.62%). Among females, the standardized proportion of unspecified malignant neoplasm of breast was higher in coal mine workers group than in the general population group(2.60% vs 2.09%). Conclusion Neoplasms, abnormal symptoms, and mental health disorders should be prioritized in disease prevention strategies for coal mine workers. Greater attention should be paid to mental health screening in younger populations, and medical resource allocation should be optimized according to sex-specific high-incidence cancers.更多还原