Singh Virendra, Meena Hardayal, Bairwa Ramavatar, Singh Sheetu, Sharma Bharat Bhushan, Singh Ajeet
Department of Medicine, Division of Allergy and Pulmonary Medicine, SMS Medical College and Hospital, Jaipur, Rajasthan, India.
Lung India. 2015 Mar-Apr;32(2):102-6. doi: 10.4103/0970-2113.152614.
Anthracosis is the black pigmentation of the mucosal lining of the tracheo-bronchial tree. The significance of this finding is not known and often ignored. The aim of the present study is to find the association of anthracosis with demographic variables, biomass fuel and occupational exposure, respiratory diseases, radiological pattern and functional morbidity.
Enrolment of the subjects for the study was done at SMS hospital, Jaipur. Patients with anthracosis evident on bronchoscopy were included as the cases. Patients without anthracosis on bronchoscopy, matched according to age, gender and smoking habits, were included in the control group. Subjects in both the arms completed a questionnaire and also underwent computed tomography (CT) of the chest and six minute walk test (6MWT).
Thirty cases and 53 controls were included in the study. The patients with anthracosis presented with symptoms ranging from cough (76.65%), hemoptysis (46.6%), fever (26.6%), dyspnea (90%) and malaise (73.3%). Biomass fuel exposure for the cases was 35.13 ± 55.86 hours in a year and for the controls was 28.15 ± 40.09 hours in a year (P > 0.05). Stone mining was significantly associated with anthracosis (P < 0.05). CT chest revealed fibrosis (43.3%), consolidation (33.3%), cavitation (16.6%) and mass (46.6%) in the cases. Sixty percent of cases and 15% of controls were diagnosed to have either old or active pulmonary tuberculosis (P < 0.05).
Anthracosis is associated with pulmonary tuberculosis. Biomass exposure is not significantly associated with anthracosis. Post tubercular fibrosis is more common on CT chest of patients with anthracosis.
肺炭末沉着症是气管 - 支气管树黏膜内衬的黑色色素沉着。这一发现的意义尚不清楚,且常被忽视。本研究的目的是找出肺炭末沉着症与人口统计学变量、生物质燃料和职业暴露、呼吸系统疾病、放射学模式及功能发病率之间的关联。
在斋浦尔的SMS医院招募研究对象。支气管镜检查显示有明显肺炭末沉着症的患者作为病例组。支气管镜检查无肺炭末沉着症、根据年龄、性别和吸烟习惯匹配的患者纳入对照组。两组受试者均完成一份问卷,并接受胸部计算机断层扫描(CT)和六分钟步行试验(6MWT)。
本研究纳入了30例病例和53例对照。肺炭末沉着症患者出现的症状包括咳嗽(76.65%)、咯血(46.6%)、发热(26.6%)、呼吸困难(90%)和不适(73.3%)。病例组每年接触生物质燃料的时间为35.13±55.86小时,对照组为28.15±40.09小时(P>0.05)。采石与肺炭末沉着症显著相关(P<0.05)。胸部CT显示病例组有纤维化(43.3%)、实变(33.3%)、空洞形成(16.6%)和肿块(46.6%)。60%的病例组和15%的对照组被诊断患有陈旧性或活动性肺结核(P<0.05)。
肺炭末沉着症与肺结核有关。生物质暴露与肺炭末沉着症无显著关联。肺炭末沉着症患者胸部CT上结核后纤维化更常见。