矽肺矿工肺结核患病情况及结核菌素反应的调查分析  

Prevalence of Pulmonary Tuberculosis and Analysis of Tuberculin Reaction among Miners with Silicosis

作　　者：唐云霞 曲亚斌[2] 李华 景涛 朱人[2] 顾寿永[2] 夏昭林[2] 

机构地区：[1]马钢(集团)股份有限公司医院,安徽马鞍山243003 [2]复旦大学公共卫生学院劳动卫生学教研室,上海200032

出　　处：《环境与职业医学》2005年第3期261-263,共3页Journal of Environmental and Occupational Medicine

摘　　要：[目的]调查矽肺矿工中肺结核的流行情况,评估非结核矿工对结核菌素的反应性。[方法]病例对照设计,选择189例男性矽肺病人为病例,110例无矽肺的接尘矿工为对照。调查所有研究对象肺结核患病情况、职业史,并将接尘工龄划分为3组(<20年,20年-,30年-)。剔除肺结核患者59人,对其余矿工进行PPD皮肤试验。[结果]Ⅰ期矽肺组肺结核合并率为16.4%,Ⅱ期为29.0%,Ⅲ期为72.7%。对照组矿工中接尘工龄≥30年者肺结核患病率最高。Ⅱ期矽肺组结核菌素反应强阳性率为22.7%,高于对照组的8.3%。有明确的结核病接触史者,结核菌素反应阳性和强阳性率高于无结核病接触史者。[结论]随着矽肺期别升高,肺结核患病率增加。PPD皮肤试验可以作为矽肺患者合并肺结核的初筛手段之一。[Objective] To investigate the prevalence rate of pulmonary tuberculosis (PTB) among miners with silicosis and evaluate the responses of non-tuberculosis miners to tuberculin. [Methods] A case-control study of 189 male patients with silicosis as a case group and 110 male non-silicosis miners as a control group was conducted. The prevalence rates of PTB among all subjects was investigated, and all subjects were divided into three groups according to years of dust exposure(<20,20-, 30-year). The purified protein derivative of tuberculin(PPD) test was carried out in miners except 59 persons with PTB. [Results] Prevalence rates of PTB were 16.4% at stage Ⅰ silicosis,29.0% at stage Ⅱ silicosis and 72.7% at stage Ⅲ silicosis,respectively. PTB prevalence rate was the highest in the group exposed to dust more than 30 years among non-silicosis miners.The excessive positive rate of tuberculin reaction at stage Ⅱ silicosis was higher than that of non-silicosis group,22.7% and 8.3% respectively. Individuals who had been exposed to tubercle bacillus were more sensitive to tuberculin reaction than non-exposed people. [Conclusion] The prevalence rate of PTB increased with stage of silicosis upgrading.PPD test may be acted as a screening measure for pulmonary tuberculosis in silicosis miners.

关 键 词：矽肺 肺结核 结核菌素试验 

分 类 号：R135.2[医药卫生—劳动卫生]