Taguchi O, Saitoh Y, Saitoh K, Fuyuki T, Shida H, Mishina M, Chiyotani K, Honma K
Department of Internal Medicine, Keihai-Rosai Hospital, Fujihara, Japan.
Am J Ind Med. 2000 Mar;37(3):260-4. doi: 10.1002/(sici)1097-0274(200003)37:3<260::aid-ajim3>3.0.co;2-w.
To assess the relationship between mixed dust fibrosis (MDF) and tuberculosis.
We performed a comparative analysis with MDF, silicosis, and macular pneumoconiosis (Mac), using autopsy records from 1975 to 1994.
Prevalences of having tuberculosis among MDF, silicosis, and Mac were not significantly different, albeit a tendency of higher prevalence in silicosis. Cure rates of tuberculosis were, in order, silicosis < MDF < Mac (P=0. 085). Death rates associated with tuberculosis were, in order, silicosis > MDF=Mac (P=0.911). With respect to the two types of association with tuberculosis, i.e., combined type (tuberculopneumoconiosis) and complicated one (pneumoconiosis with tuberculosis); the former was significantly dominant in silicosis, the latter was significantly dominant in Mac, and intermediate in MDF. As a whole, the complicated type had a tendency of a higher cure rate than the combined type (P=0.071). Although the differences of profiles between the combined and complicated types were not statistically significant, the combined type had a tendency to have longer duration of exposure to dusts, earlier registration for treatment, higher profusion score, and earlier death compared with the complicated type.
From our findings, MDF takes an intermediate position between silicosis and Mac regarding the relationship with tuberculosis. The type of association with tuberculosis rather than the kind of background pneumoconiosis seemed to be more important in light of responsiveness to the treatment.
评估混合性粉尘纤维化（MDF）与肺结核之间的关系。
我们利用1975年至1994年的尸检记录，对MDF、矽肺和斑点状尘肺（Mac）进行了对比分析。
MDF、矽肺和Mac中患肺结核的患病率无显著差异，尽管矽肺患病率有较高的趋势。肺结核的治愈率依次为矽肺＜MDF＜Mac（P = 0.085）。与肺结核相关的死亡率依次为矽肺＞MDF = Mac（P = 0.911）。关于与肺结核的两种关联类型，即合并型（结核性尘肺）和并发型（尘肺合并肺结核）；前者在矽肺中显著占主导，后者在Mac中显著占主导，在MDF中处于中间状态。总体而言，并发型的治愈率有高于合并型的趋势（P = 0.071）。尽管合并型和并发型之间的特征差异无统计学意义，但与并发型相比，合并型有接触粉尘时间更长、治疗登记更早、肺野密集度评分更高和死亡更早的趋势。
根据我们的研究结果，在与肺结核的关系方面，MDF在矽肺和Mac之间处于中间位置。就治疗反应而言，与肺结核的关联类型似乎比背景尘肺的类型更重要。
