Jones F L
Am Rev Respir Dis. 1982 Jun;125(6):681-3. doi: 10.1164/arrd.1982.125.6.681.
The outcomes of 20 anthracite miners with coal workers' pneumoconiosis and culture-proved pulmonary tuberculosis treated with rifampin-containing chemotherapeutic regimens were determined by a retrospective review. Their mean age was 65 yr, and the duration of underground dust exposure averaged 27 yr. Nine miners had simple pneumoconiosis, 11 had progressive massive fibrosis, and 13 had cavitary disease; 3 also had extrapulmonary disease. All patients were given rifampin (mean, 12 months in survivors) plus one or more other effective agents; the mean duration of treatment with 2 or more drugs was 17 months. Follow-up averaged 46 months in those surviving more than 1 yr. Sputum cultures became negative and remained so within 3 months in 17 patients and within 5 months in the remainder. Eighteen patients survived more than 1 yr after completing chemotherapy. No clinical, radiologic, or bacteriologic relapses were observed during follow-up, but 5 patients died of nontuberculous causes. These results are superior to those reported previously in patients with coal workers' pneumoconiosis treated for pulmonary tuberculosis with regimens not containing rifampin. They suggest that treatment of tuberculosis in coal workers, even in the presence of progressive massive fibrosis and cavitary disease, can yield results as favorable as in nonpneumoconiotic patients provided the initial treatment regimen includes rifampin plus one or more other effective agents.
通过回顾性研究确定了20名患有煤工尘肺且经培养证实患有肺结核的无烟煤矿工接受含利福平化疗方案治疗的结果。他们的平均年龄为65岁，井下粉尘接触时间平均为27年。9名矿工患有单纯尘肺，11名患有进行性大块纤维化，13名患有空洞性疾病；3名还患有肺外疾病。所有患者均接受利福平治疗（幸存者平均治疗12个月）加一种或多种其他有效药物；使用两种或更多药物的平均治疗时间为17个月。存活超过1年的患者平均随访46个月。17例患者痰液培养在3个月内转阴并一直保持阴性，其余患者在5个月内转阴。18例患者完成化疗后存活超过1年。随访期间未观察到临床、影像学或细菌学复发，但5例患者死于非结核原因。这些结果优于先前报道的用不含利福平的方案治疗煤工尘肺合并肺结核患者的结果。这表明，即使存在进行性大块纤维化和空洞性疾病，只要初始治疗方案包括利福平加一种或多种其他有效药物，煤工尘肺合并肺结核的治疗效果可与非尘肺患者一样良好。
