Division of Pulmonary and Critical Care Medicine, Fatima Hospital, Daegu, South Korea.
Respir Med. 2009 May;103(5):757-65. doi: 10.1016/j.rmed.2008.11.011. Epub 2008 Dec 25.
The presenting features and clinical course of biomass smoke induced bronchial anthracofibrosis (BAF) are not well known.
333 patients who had a history of long-term exposure to biomass smoke, having BAF confirmed by a bronchoscopy from January 1998 to December 2004, were included in this study. The clinical features, associated diseases, and clinical outcomes were investigated through the analysis of medical records.
There were 51 males (15.3%) and 282 females (84.7%), having a mean age of 72.3 years, ranging from 47 to 90. 33% of patients had a past history of pulmonary tuberculosis. Dyspnea (38.4%) and cough (29.8%) were most common presenting symptoms, followed by hemoptysis (8.9%). Baseline pulmonary function showed mild airflow obstruction. Among patients with forced expiratory volume in 1s (FEV(1))/forced vital capacity (FVC)<0.7, Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages I and II were most common. Associated diseases were active tuberculosis in 33.9% of patients, pneumonia in 29.5%, acute exacerbation of chronic airways disease in 22.5%, and malignancy in 4.8%. Among the 18 patients who died at a hospital during the follow-up period, acute infection and malignancy were common causes of death.
These findings suggest that biomass smoke induced BAF usually appears clinically as a form of obstructive airways disease. Since various pulmonary diseases, including tuberculosis, pneumonia, and malignancy, can be associated with BAF, thorough clinical evaluation and close follow-up of these patients are required.
生物质烟雾引起的支气管炭末沉着症（BAF）的临床表现和临床过程尚不清楚。
1998 年 1 月至 2004 年 12 月期间，通过支气管镜检查确诊为 BAF 且有长期接触生物质烟雾史的 333 例患者纳入本研究。通过分析病历，调查了临床特征、相关疾病和临床结局。
51 例（15.3%）为男性，282 例（84.7%）为女性，平均年龄为 72.3 岁，年龄 47~90 岁。33.9%的患者有肺结核病史。呼吸困难（38.4%）和咳嗽（29.8%）是最常见的症状，其次是咯血（8.9%）。基线肺功能显示轻度气流阻塞。用力肺活量（FEV1）/用力肺活量（FVC）<0.7 的患者中，慢性阻塞性肺疾病全球倡议（GOLD）I 期和 II 期最常见。相关疾病包括 33.9%的患者活动性肺结核、29.5%的患者肺炎、22.5%的患者慢性气道疾病急性加重和 4.8%的患者恶性肿瘤。在随访期间死亡的 18 例患者中，急性感染和恶性肿瘤是常见的死亡原因。
这些发现表明，生物质烟雾引起的 BAF 通常表现为阻塞性气道疾病。由于包括肺结核、肺炎和恶性肿瘤在内的各种肺部疾病都可能与 BAF 相关，因此需要对这些患者进行彻底的临床评估和密切随访。
