Analysis of clinical characteristics of silicosis complicated with active pulmonary tuberculosis / 中国热带医学

ABSTRACT

@#Abstract Objective　To investigate the clinical characteristics of silicosis complicated with active pulmonary tuberculosis. Methods A retrospective analysis of 36 patients with silicotuberculosis and 100 patients with active pulmonary tuberculosis was performed from January 2018 to December 2021 at Beijing Chest Hospital，Capital Medical University. The patients were confirmed by etiology or pathology. The patients with silicotuberculosis were designed to observation group and the patients with active pulmonary tuberculosis were designed to control group. The enumeration data were expressed as percentage and were treated with the chi-square test and the nonnormal distribution data is expressed as M(P25, P75). The difference was significant with P<0.05. Results　In the observation group, there were 7 cases (19.4%) of silicosis in stage Ⅰ, 14 cases (38.9%) in stage Ⅱ and 15 cases (41.7%) in stage Ⅲ. 25 cases (69.4%, χ2=17.099) had a course of TB more than 12 months. 32 cases (88.9%, χ2=16.722) with cough, expectoration and dyspnea as the main symptoms. 32 cases (88.9%, χ2=16.722) had nodular lesions, and 30 cases (83.3%, χ2=19.900) had mediastinal and hilar lymphadenopathy as the main imaging manifestations on chest CT. 17 cases (47.2%, χ2=7.481) were misdiagnosed. Compared with the control group, the difference was significant in these aspects (P<0.05). 27 cases in the observation group were followed up, 1 case died after 5 months of treatment. The negative conversion time of Mycobacteria growth indicator tube (MGIT) liquid culture in sputum was within 2 months in 17 cases (65.4%), between 2 and 12 months in 5 cases (19.2%) and over 12 months in 4 cases (15.4%), and a significant difference was observed comparing with the control group (P<0.05). Conclusions　The patients with silicotuberculosis are mainly in stage Ⅱ and stage Ⅲ with long duration of TB, cough, expectoration and dyspnea as the main symptoms. Chest CT shows that nodules, mediastinal and hilar lymphadenopathy are the main imaging manifestations. And the silicotuberculosis was easily misdiagnosed. At the same time, screening for latent tuberculosis infection in silicosis patients indispensable due to the poor prognosis of anti-tuberculosis treatment.