联合治疗矽肺结核的临床观察

目的 探讨结核化疗中加服抗痨胶囊治疗矽肺结核的临床疗效.方法 选取我县结防门诊新涂阳矽肺结核病人66例,予同一方案化疗,其中32例为实验组,加服抗痨胶囊6个月.两组病人均为男性,年龄、痰菌及肺部病变无统计学差异.结果 治疗二月末痰菌阴转率实验组100%（32/32）,对照组82.35%（28/34） P＜0.05.治疗九个月末肺部病变明显吸收好转率实验组87.5%（28/32）,对照组61.76%（21/34） P＜0.05.停药后两年随访,肺气肿进展率实验组15.62%（5/32）,对照组（肺心病死亡1例）42.42%（14/33） P＜0.05.结论 实验组经化疗痰菌阴转及肺内结核病变吸收优于对照组,肺气肿进展率低于对照组.     

218例尘肺结核分期化疗方案的临床研究

目的探讨尘肺结核菌阳初治患者根据尘肺分期使用不同疗程化疗方案的近远期疗效。方法按尘肺分期及病灶范围分为4组（A₁、A₂、B₁、B₂）给予不同的化疗方案,全程督导治疗结束并随访5年。考核痰菌的阴转率、复阳率,并进行各组间比较。结果4组病例化疗疗程结束痰菌阴转率达到100%,随访5年期间痰菌复阳率分别为17.4%、4.3%、22.5%、5.0%。结论A₂组方案3HRZS(E)/6HRZ/9HRE适用于Ⅰ～Ⅱ期尘肺结核,B₂组方案3HRZS(E)/9HRZ/12HRE适用于Ⅲ期尘肺结核,对该组方案的远期疗效满意。     

Analysis of Q fever in Uruguay

The first outbreak of Q fever in Uruguay occurred in 1956. The infection, which is caused by Coxiella burnetti, occurs in sheep, cattle, swine, and horses, but not in fowl or guinea pig. Most of the cases studied have been traced to cattle. Fourteen outbreaks of this disease were studied between 1975 and 1985. All of the 1,358 clinically suspected cases (814 serologically confirmed) reported in Uruguay occurred in workers at meat-processing plants. Diagnoses of cases and serologic surveys were made by use of complement fixation, capillary agglutination, and layer microagglutination techniques.     

Pulmonary complications in lead miners

We carried out a study to assess the prevalence of respiratory disease in lead miners and to investigate the roles of silica and lead. We used a questionnaire for symptoms and examinations for signs of respiratory disease, chest roentgenograms, and spirometric study in 45 lead miners. Six underwent bronchoscopy and transbronchial lung biopsy (TBB) and five lung lead analysis. Lung lead levels from five patients with no occupational lead exposure were obtained for comparison. Results showed restriction in five of 45 and reticulonodular opacities in 16 of 45 workers. Squamous metaplasia and other histopathologic changes were observed, although silicotic nodules were absent by TBB. Lung lead levels above those of control subjects were observed in four of five lead miners. These findings show that lead miners are at risk for lung disease. Although silica is a likely cause, elevated lung lead content found in these miners merits further investigation.