低剂量CT对长工龄煤矿职-rB,结核筛查的意义

Significance of low-dose CT in pulmonry tuberculosisby screening of coal miners with long working age

目的探讨低剂量CT（LDCT）对较长工龄煤矿职工肺结核筛查的意义。方法选择907例煤矿职工，男863例，女44例，平均年龄49．5岁，井下工龄〉20年332例、10—20年278例、〈10年297例，所有病例连续3年均行LDCT体检。结果基线LDCT：检出肺结核临床治愈或无活动性65例，井下工龄〉20年及10—20年的患病率明显高于井下工龄〈10年，差异有统计学意义（P〈0．05）；检出活动性肺结核2例，均为井下工龄10-20年。两个年度复查LDCT：1例肺结核临床治愈复发。结论应用基线LDCT对煤矿职工肺结核筛查意义重大，特别对于井下工作超过10年的职工要作为重点筛查对象；应用年度复查LDCT可以动态观察活动性肺结核治疗情况，及时发现肺结核临床治愈或无活动性的复发病例。

Objective To investigate the significance of low-dose CT（LDCT） in pulmonry tu- berculosisby screening of coal miners who had with long working age. Methods A total of 907 coal min- ers （ male 863, female 44）, with an average age at 49. 5 years old, were examined by LDCT once a year for 3 years. Of the 907 coal mines, 863 cases were males and 44 cases were females. A total of 332 coal miners had been working underground for over 20 years, 278 cases for 10 to 20 years, 297 cases for 〈 10 years. Results The LDCT examination results of the first year showed that 65 cases of clinically cured or stable stage pulmonry tuberculosis were checked out. The prevalence rates were higher in underground coal miners who worked over 20 years and 10 to 20 years than the coal miners who worked 〈 10 years, the differences were significant （P 〈 0. 05 ）. And 2 cases of active pulmonary tuberculosis were checked out. Both of them had been working underground fo10-20 years. The results in the next two years showed that： 1 case of pulmonary tuberculosis relapsed after clinical cure. Conclusions It is very necessary to screen pulmonry tuberculosis by LDCT in coal miners＇ chest physical examination, especially for coal miners who have been working underground 〉 10 years. The annual LDCT examination can dynamically observe the curative effect of active pulmonary tuberculosis, and find out clinically cured or inactive re- current cases of pulmonry tuberculosis.