Case Characteristics Analysis Of Bronchial Anthracosis And Bronchial Anthracofibrosis

ObjectiveTo investigate the clinical manifestations,radiographic feature,bronchoscopy findings and related disease characteristics of patients with bronchial anthracosis(BAC)and bronchial anthracofibrosis(BAF),and to raise the awareness attention of clinicians on bronchial anthracosis.MethodsA retrospective analysis of the clinical data of 77 patients with BAC and 179 patients with BAF.The patients were diagnosed by bronchoscopy,which showed pigmentation of bronchial mucosa and with the main or segmental bronchial stenosis or obliteration,confirmed as bronchial anthracofibrosis.All the patients was performed in the department of Respiratory and Critical Care Medicine,General Hospital of Ningxia Medical University from June 2016 to June 2017.The clinical data included the general characteristics,clinical symptoms,laboratory and bronchoscopy examination,radiographic feature and related diseases were retrospectively analyzed.The clinical characteristics of the patients in the BAC and BAF groups were compared.Results256 inpatients,77 in BAC group and 179 in BAF group were collected.Most patients were female,with 41 cases in BAC group(53.2%)and 105 cases in BAF group(58.7%).The age of onset was between 60 and 80 years old,and the age of onset in BAF group was higher than BAC group(P<0.05).Most patients were farmers,with 47 cases in BAC group(61.0%)and 103 cases in BAF group(57.5%).Most of the patients presented with chronic disease course.38 patients in the BAC group(49.3%)and 89 patients in the BAF group(49.7%)had chronic disease course lasting more than 3 months.The main clinical symptoms were cough,expectoration and dyspnea,especially in BAF group(P<0.05).In terms of laboratory examination,most of the patients had increased esr and c-reactive protein,and there was no statistical difference between the two groups.In terms of sputum bacteria detection,the positive rate of acid-fast bacteria detection was not high in both groups.In the detection of sputum fungi,the positive rate of BAF group was higher than BAC(P<0.05).Among the tumor markers,there was a statistical difference between the two groups in the increase of CA125(P<0.05).CT findings of the chest showed that in addition to bronchial stenosis,there were statistically significant differences in atelectasis,mass shadow,mediastinal and hilar lymph node enlargement and calcification in the BAF group compared with the BAC group(P<0.05).Mixed ventilation dysfunction was more common in BAF group than BAC group.Under bronchoscopy,the majority of pigmentation in BAF group was in multiple pulmonary lobes(P<0.05),and the majority was in the upper lobe of the right lung.In the BAF group,bronchial stenosis was more common in the upper lobe of the right lung,and occlusion was more common.The incidence of pulmonary tuberculosis,pulmonary infection and pulmonary hypertension in BAF was higher than BAC group.Conclusion1.Most of the BAC and BAF patients are elderly women,and most of them are rural patients.2.Most of the patients were chronic patients with chronic cough,expectoration and dyspnea,and dyspnea was more common in the BAF group;3.Chest CT showed multiple lymph node enlargement or calcification in the mediastinum and hilum,which was more common in the BAF group;4.Under bronchoscopy,pigmentation was mainly in multiple pulmonary lobes in the BAF group.Pigmentation and bronchial stenosis were common in the upper lobe of right lung,while atelectasis and occlusion were common in the middle lobe of right lung.5.The incidence of pulmonary tuberculosis,pulmonary infection and pulmonary arterial hypertension was higher in the BAF group.