摘要：
尘肺是我国现阶段最主要、最严重的职业病病种之一.近年来全国肺结核报告发病例数仅次于病毒性肝炎,居甲乙类传染病第二位.肺结核是尘肺患者常见的并发症,发病常由多种因素联合作用所致.作者介绍了近年来各地的尘肺患者并发肺结核的发生率,分析了有关其发病易感因素的各项研究,得出目前各地尘肺患者并发肺结核的发生率仍较高的结论.现已发现可能的易感因素有尘肺期别、发病年龄、接尘工龄、工种、接尘年代等职业易感因素,以及基因、预防用药等其他易感因素.近年的相关研究,针对尘肺并发结核病的诊断、治疗较多,而针对患病原因和如何预防控制的较少.现有的研究存在各种不足和分歧,也还需要进一步验证.建议针对接触尘埃的工人和尘肺患者加强定期体检,及时发现尘肺及尘肺并发肺结核的患者,特别是具有易感因素的人群(尘肺期别高、接尘工龄长、接尘年代早、掘进工等),应作为预防重点,特别加以关注,以达到控制、降低尘肺患者并发肺结核发生率的目的.%Pneumoconiosis is one of the most important and serious occupational diseases in China. In recent years,the number of notified pulmonary tuberculosis (PTB) ranks as the second place in the class A and B infectious diseases after viral hepatitis. PTB is a common complication among pneumoconiosis patients and is caused by a combination of various factors. This article introduced the incidence of PTB in patients with pneumoconiosis in recent years in different areas of China,and analyzed the researches on the susceptible factors for developing PTB. It is concluded that the incidence of PTB is still high in patients with pneumoconiosis. The results showed that the possible susceptible factors included: the stage of pneumoconiosis, age of onset, the years exposure to dust, type of work,the age of exposure to dust and other occupational susceptible factors, as well as other susceptible factors such as gene and preventive medication. In recent years, the related researches more aimed at the diagnosis and treatment of pneumoconiosis tuberculosis, but less on the cause of the disease and how to prevent and control the disease. The existing researches have various shortcomings and differences,and need to be further verified. Through our study, we suggest that the regular physical examinations to the workers exposed to dust and the patients with pneumoconiosis should be strengthened to timely detect the patients with pneumoconiosis and the pneumoconiosis patients complicated with PTB. Populations with the susceptible factors for developing PTB, such as the pneumoconiosis patients at higher pneumoconiosis stage, workers with longer time exposure to dust or earlier age exposure to dust and engaging in excavation work, etc., should be regarded as the key populations of prevention and give special attentions. So the incidence of pulmonary tuberculosis in patients with pneumoconiosis can be reduced and the pneumoconiosis tuberculosis can be effectively controlled.
