Ahmed Khalid, Sumalani Kamran K, Akhter Nousheen, Ahmed Maqbool, Baqi Abdul, Rizvi Nadeem
Pulmonology, Fatima Jinnah General and Chest Hospital, Quetta, PAK.
Pulmonology, Jinnah Postgraduate Medical Centre, Karachi, PAK.
Cureus. 2024 Nov 12;16(11):e73499. doi: 10.7759/cureus.73499. eCollection 2024 Nov.
Introduction Anthracosis is black discoloration of the bronchi, which can sometimes cause anthracofibrosis. Usually, exposure to biomass fuel, air pollution, or smoke at the workplace causes it. The objective of the current study was to determine the association between tuberculosis and anthracosis. Methods Patients with chronic dyspnea, dry cough, and infiltrates or mass lesions on chest X-rays underwent bronchoscopic lavage and biopsy where needed. Patients were divided into two groups on the basis of anthracosis on bronchoscopy. Diagnosis of tuberculosis was made on bronchial wash acid-fast bacilli smear, mycobacterial culture, or Xpert Mycobacterium tuberculosis (MTB) rifampicin (RIF) assay. Results Tuberculosis was diagnosed by bronchoscopy in 68/173 (39.30%) patients with anthracosis which was significantly higher (p-value 0.020) than the control group (43/159, 27.04%). Most of the cases (54/68, 79.41%) had positive Xpert assay. The male-to-female ratio was 3:1, and all the females with anthracosis were homemakers and used biomass fuel. Conclusion Patients with exposure to smoke are prone to develop anthracosis. The presence of anthracosis is associated with the development of tuberculosis. Appropriate investigations for tuberculosis must be done in subjects undergoing bronchoscopy who are found to have anthracosis. Expanding understanding among the masses regarding the hazards of using biomass fuel in closed spaces can be a crucial measure toward diminishing the chance of developing anthracosis and the concomitant risk of tuberculosis.
引言
煤尘肺是支气管的黑色色素沉着,有时可导致煤尘纤维变性。通常,接触生物质燃料、空气污染或工作场所的烟雾会引发该病。本研究的目的是确定结核病与煤尘肺之间的关联。
方法
对有慢性呼吸困难、干咳且胸部X光片有浸润或块状病变的患者,必要时进行支气管灌洗和活检。根据支气管镜检查发现的煤尘肺情况将患者分为两组。通过支气管冲洗抗酸杆菌涂片、分枝杆菌培养或Xpert结核分枝杆菌(MTB)利福平(RIF)检测来诊断结核病。
结果
在173例煤尘肺患者中,通过支气管镜诊断出结核病的有68例(39.30%),这一比例显著高于对照组(43/159,27.04%)(p值为0.020)。大多数病例(54/68,79.41%)Xpert检测呈阳性。男女比例为3:1,所有患煤尘肺的女性均为家庭主妇且使用生物质燃料。
结论
接触烟雾的患者易患煤尘肺。煤尘肺的存在与结核病的发生有关。对于在支气管镜检查中发现有煤尘肺的患者,必须进行适当的结核病检查。提高大众对在封闭空间使用生物质燃料危害的认识,可能是降低患煤尘肺几率及随之而来的结核病风险的关键措施。