Mirsadraee M H, Asnashari A K, Attaran D M
Internist and Subspecialty in Pulmonary Medicine, Islamic Azad University, Mashhad Branch, Mashhad, Iran.
Iran Red Crescent Med J. 2011 Sep;13(9):670-3. doi: 10.5812/kowsar.20741804.2247. Epub 2011 Sep 15.
Anthracosis is the black pigment discoloration of bronchi with an unknown cause which can cause bronchial destruction and deformity (anthracofibrosis). The objective of this study was to determine the frequency of tuberculosis in anthracosis and evaluate their association.
One hundred and twenty subjects with bronchoscopy diagnosis of simple anthracosis, anthracofibrosis and non-anthracotic control groups entered this study. Demographic data and important clinical and radiological findings were recorded. Bronchial biopsy and bronchoalveolar lavage were performed for further cytopathological, acid-fast bacilli staining and culture in all cases.
Cough and dyspnea were significantly higher in anthracosis subjects. Radiological characteristic of tuberculosis such as upper lobe localization and cavity were not significantly higher in anthracosis subjects that suffer from tuberculosis. Laboratory test for tuberculosis showed positive acid fast bacilli in 17.5 and 25% and caseating granuloma in 20 and 17.5% of anthracosis and anthracofibrosis subjects. Adding the result of culture, the frequency of tuberculosis in both groups of anthracosis was 27.5% that was significantly more than nonanthracotic control group (Odd ratio= 6.15, CL=1.29<OR<40.06).
Anthracosis and tuberculosis showed a significant association. Anti-tuberculosis therapy promised better treatment of anthracosis in subjects proved to suffer from tuberculosis.
煤尘肺是支气管的黑色色素沉着，病因不明，可导致支气管破坏和畸形（煤尘性纤维变性）。本研究的目的是确定煤尘肺中结核病的发生率并评估它们之间的关联。
120名经支气管镜诊断为单纯煤尘肺、煤尘性纤维变性的受试者以及非煤尘肺对照组进入本研究。记录人口统计学数据以及重要的临床和放射学检查结果。对所有病例均进行支气管活检和支气管肺泡灌洗，以进行进一步的细胞病理学检查、抗酸杆菌染色和培养。
煤尘肺患者咳嗽和呼吸困难的发生率明显更高。患有结核病的煤尘肺患者中，结核病的放射学特征（如位于上叶和有空洞）并不明显更高。结核病实验室检查显示，煤尘肺和煤尘性纤维变性患者中抗酸杆菌阳性率分别为17.5%和25%，干酪样肉芽肿发生率分别为20%和17.5%。加上培养结果，两组煤尘肺患者的结核病发生率为27.5%，明显高于非煤尘肺对照组（比值比=6.15，可信区间=1.29＜比值比＜40.06）。
煤尘肺与结核病之间存在显著关联。对于经证实患有结核病的患者，抗结核治疗有望更好地治疗煤尘肺。
