مقايسه تظاهرات باليني و پاراكلينيكي بيماران مبتلا به برونشيت آنتراكوتيك با بيماران مبتلا به COPD ناشي از دود سيگار

The Comparison of the Clinical and Para-clinical Findings of Antrachotic Bronchitis Patients with Smoke Induced COPD Patients

Background and Aim: previous studies in the developing countries showed that some of the presentations of chronic obstructive pulmonary disease (COPD) had been observed in the patients with no history of smoking or industrial or occupational exposure, but presence of anthracotic plaque had been reported in their bronchoscopy. The aim of this study was to compare the clinical and para-clinical findings in antrachotic bronchitis patients with those of smoke induced COPD patients. Material and Methods: This was a cross-sectional study. Among 170 patients who had undergone bronchoscopy, 40 patients had antrachotic bronchitis and history of exposure to wood or other biomass smoke. The demographic characteristics, clinical and radiologic findings of these patients were compared with those of another 45 patients with diagnosis of smoke induced COPD (with exposure to wood and other biomass smoke), whose diagnosis had been based on clinical, spirometrical and radiological findings. Data were introduced into SPSS software and analyzed by means of descriptive statistics, Chi square, Fisherʹs exact test and t-test. Results: Among patients with anthracotic bronchitis 70% were house wife, 75% female, and 80% were from rural areas. But in COPD patients 40% were farmer, 84.4% men, and 57.8% were living in rural areas (P<0.05). There were no significant differences in clinical findings such as cough, hemoptysis, sweating, and weight loss between the two groups. The most common radiological findings in anthracotic bronchitis patients were lung infiltration (77/5%), right lung infiltration (67/5%), and reticular lung opacity (40%) and in COPD patients the most common findings were increased broncho vascular marking of the lung (100%), hyper airiation of lung (92.5%), and calcification of hilar lymph nodes (12.5%). The most common findings and anthracotic plaques in bronchoscopy of anthracotic bronchitis patients were located in lobar bronchus (94.6%) and main bronchus (37.1%), but deformity was seen in 36.4%> of them. Conclusion: Our results suggest that, in patients with clinical presentation of COPD who had not a clear-cut history of occupational or other risk factors, taking an exact history of exposure to wood or biomass smoke and also living in rural area as main risk factors for anthracotic bronchitis should be taken into consideration.