Department of Radiology, Haydarpasa Numune Research and Training Hospital, 34668, Istanbul, Turkey.
Department of Radiology, Capa Medical Faculty, Istanbul University, 34093, Istanbul, Turkey.
Int Health. 2017 Mar 1;9(2):118-123. doi: 10.1093/inthealth/ihw057.
Lungs are particularly vulnerable to both acute infections, including TB, and chronic diseases such as chronic obstructive pulmonary disease, as well as to malignancies, all of which require particular attention during war times in which health conditions are far from optimal.
This retrospective cross-sectional study included 1149 refugees that underwent thoracic computed tomography (CT) for respiratory symptoms between March 2013 and February 2015 in Turkey.
At least one positive CT finding was seen in 231 (20.1%) of the patients. The most common findings were chronic pulmonary changes (n=197, 17.2%), followed by findings suggestive of infections (n=39, 3.4%), and mass/nodular lesions (n=16, 1.4%). The rates of the lesions suggestive of active TB and malignancy were 1.0% (n=11) and 0.7% (n=8), respectively. Age 55-64 years was an independent significant predictor for any CT lesion, chronic changes, mass lesions, and lesions suggestive of malignancy. Age>65 years was predictive of any CT lesion and chronic changes.
The findings of this study indicate the need for implementation of cost-effective screening strategies in refugees, particularly during war times. Screening for TB would improve disease control among both refugees and the host populations. Middle aged and older individuals, in particular, would benefit from more proactive screening tools and strategies for the early diagnosis of pulmonary malignancies and chronic lung diseases.
肺部特别容易受到急性感染（包括结核病）和慢性疾病（如慢性阻塞性肺疾病）以及恶性肿瘤的影响，所有这些在健康状况远非最佳的战争时期都需要特别关注。
本回顾性横断面研究纳入了 2013 年 3 月至 2015 年 2 月期间在土耳其因呼吸系统症状接受胸部计算机断层扫描（CT）的 1149 名难民。
至少有 1 个阳性 CT 发现见于 231 名（20.1%）患者中。最常见的发现是慢性肺部改变（n=197，17.2%），其次是提示感染的发现（n=39，3.4%）和肿块/结节性病变（n=16，1.4%）。提示活动性肺结核和恶性肿瘤的病变发生率分别为 1.0%（n=11）和 0.7%（n=8）。55-64 岁年龄是任何 CT 病变、慢性改变、肿块病变和提示恶性肿瘤的病变的独立显著预测因素。年龄>65 岁是任何 CT 病变和慢性改变的预测因素。
本研究结果表明，需要在难民中实施具有成本效益的筛查策略，特别是在战争时期。筛查结核病将改善难民和宿主人群的疾病控制。特别是中老年人将受益于更积极的筛查工具和策略，以早期诊断肺部恶性肿瘤和慢性肺部疾病。
