泰国石材加工工人肺结核免疫能力和矽肺的关系(英文)

The Relationship between Pulmonary Tuberculosis Immunity and Silicosis Incidence among Stone Grinding Workers in Thailand

[目的]通过比较肺结核免疫人群和未免疫人群的肺结核和矽肺发病率 ,分析肺结核免疫和矽肺的关系。分析接尘矽肺病人的肺结核免疫力和矽肺反应时间的关系。[方法]X线摄片划分矽肺病组和对照组 ,匹配性别、年龄、工作地区。痰液抗酸染色、PCR和痰培养确认肺结核病例。肺结核皮试阳性但无肺结核病症状的是结核免疫的标准。[结果]结核未免疫组与免疫组发病率的差异有统计学意义 (P<0.05)。两组人群的其他危险因素没有显著差异。本研究发现结核免疫力有反应组和无反应组的反应时间 (反应时间即接触人年数 ,由接触时间乘接触粉尘浓度得出 )差异有统计学意义。[结论]粉尘接触人年数和接触时间均数与结核皮试结果相关。但结核皮试通常用于筛检 ,所以要获得可靠的结论 ,必须联用更精确的检测方法。

This research aimed to study the relationship between TB immunity and silicosis incidence by comparing incidence of pulmonary tuberculosis and silicosis in populations with and without TB immunity. The reaction time was also studied in those populations after exposure to sislica dust. According to chest radiogram the subjects were divided into a silicosis group or the control group. The sex,age and working area were matched for both groups. The sputum analysis by acid_fast staining,polymerase chain reaction and sputum culture were used to confirm the diagnosis of pulmonary tuberculosis(TB). The reaction of tuberculin skin test of the workers without TB disease was used to reveal the anti_tuberculosis immunity status. The odd ratio of TB immunity of control group to silicosis case group was 25.7. The difference was significant between two groups (P<0.05). Afterwards,it was proved that the related risk factors between case and control groups were not significantly different. In addition,the reaction time,as person exposure year was calculated by multiplying exposure time by dust exposed concentration,has a significant difference between TB immunity reactive and non_reactive groups. [Conclusion] Based on the findings of this study there is a significant association of mean person exposure year with exposure time of tuberculin skin test. Although,the skin test is usually used for screening,a highly accurate and sensitive method is still needed to be developed for more effective screening.