中华劳动卫生职业病杂志
中華勞動衛生職業病雜誌
중화노동위생직업병잡지
CHINESE JOURNAL OF INDUSTRIAL HYGIENE AND OCCUPATIONAL DISEASES
2012年
6期
439-442
,共4页
季春萍%宋海燕%徐进%王美林%侯志国%魏春龙%董秋%王守宇%乔善磊%朱宝立%倪春辉
季春萍%宋海燕%徐進%王美林%侯誌國%魏春龍%董鞦%王守宇%喬善磊%硃寶立%倪春輝
계춘평%송해연%서진%왕미림%후지국%위춘룡%동추%왕수우%교선뢰%주보립%예춘휘
二硫化碳%职业暴露%神经传导%多项筛查
二硫化碳%職業暴露%神經傳導%多項篩查
이류화탄%직업폭로%신경전도%다항사사
Carbon disulfide%Occupational exposure%Neural conduction%Multiphasic screening
目的 通过分析267例职业性慢性二硫化碳(CS2)中毒病例的临床特征,为修订我国CS2接触者职业性健康体检项目提供依据.方法 选择2006年4月至2010年5月某市职业病院诊断专家组依据GBZ 4-2002《职业性慢性二硫化碳中毒诊断标准》,诊断的职业性慢性轻度CS2中毒267例病例为研究对象.所有病例均来自同一化纤厂,初次诊断为CS2中毒时,由职业卫生专业人员以问卷调查采集详细病史及职业史,并进行神经系统、心血管系统检查,生化指标、神经-肌电图检测.结果 87.3％( 233/267)的病例出现腓总神经、正中神经、尺神经、胫后神经运动传导速度减慢,英中腓总神经和正中神经运动传导速度降低检出率分别为48.6％( 138/248),37.0％(155/419).中毒病例自觉症状以神经衰弱、肢体麻木、感觉异常为主,神经系统体征中跟腱反射(79.4％,212/267)、膝反射(49.8％,133/267)阳性检出率较高.心电图ST段改变(T波低平、T波倒置、ST段压低)检出率为19.1％(51/267);高血压、收缩压升高及舒张压升高检出率依次为27.3％( 73/267)、22.5％( 60/267)和21.1％( 59/267).乳酸脱氢酶、三酸甘油酯、低密度脂蛋白异常阳性检出率较高.男性病例的间接胆红素、直接胆红素、尿酸阳性检出率明显高于女性,并且尿素氮、间接胆红素阳性检出率随接毒工龄的延长而逐渐增加.结论 职业性慢性CS2中毒主要影响神经系统,对肝肾功能也有一定的影响.CS2作业人员职业性健康体检中,用神经肌-电图筛检运动神经损伤时,建议首先检查正中运动神经和腓总运动神经传导速度.
目的 通過分析267例職業性慢性二硫化碳(CS2)中毒病例的臨床特徵,為脩訂我國CS2接觸者職業性健康體檢項目提供依據.方法 選擇2006年4月至2010年5月某市職業病院診斷專傢組依據GBZ 4-2002《職業性慢性二硫化碳中毒診斷標準》,診斷的職業性慢性輕度CS2中毒267例病例為研究對象.所有病例均來自同一化纖廠,初次診斷為CS2中毒時,由職業衛生專業人員以問捲調查採集詳細病史及職業史,併進行神經繫統、心血管繫統檢查,生化指標、神經-肌電圖檢測.結果 87.3％( 233/267)的病例齣現腓總神經、正中神經、呎神經、脛後神經運動傳導速度減慢,英中腓總神經和正中神經運動傳導速度降低檢齣率分彆為48.6％( 138/248),37.0％(155/419).中毒病例自覺癥狀以神經衰弱、肢體痳木、感覺異常為主,神經繫統體徵中跟腱反射(79.4％,212/267)、膝反射(49.8％,133/267)暘性檢齣率較高.心電圖ST段改變(T波低平、T波倒置、ST段壓低)檢齣率為19.1％(51/267);高血壓、收縮壓升高及舒張壓升高檢齣率依次為27.3％( 73/267)、22.5％( 60/267)和21.1％( 59/267).乳痠脫氫酶、三痠甘油酯、低密度脂蛋白異常暘性檢齣率較高.男性病例的間接膽紅素、直接膽紅素、尿痠暘性檢齣率明顯高于女性,併且尿素氮、間接膽紅素暘性檢齣率隨接毒工齡的延長而逐漸增加.結論 職業性慢性CS2中毒主要影響神經繫統,對肝腎功能也有一定的影響.CS2作業人員職業性健康體檢中,用神經肌-電圖篩檢運動神經損傷時,建議首先檢查正中運動神經和腓總運動神經傳導速度.
목적 통과분석267례직업성만성이류화탄(CS2)중독병례적림상특정,위수정아국CS2접촉자직업성건강체검항목제공의거.방법 선택2006년4월지2010년5월모시직업병원진단전가조의거GBZ 4-2002《직업성만성이류화탄중독진단표준》,진단적직업성만성경도CS2중독267례병례위연구대상.소유병례균래자동일화섬엄,초차진단위CS2중독시,유직업위생전업인원이문권조사채집상세병사급직업사,병진행신경계통、심혈관계통검사,생화지표、신경-기전도검측.결과 87.3％( 233/267)적병례출현비총신경、정중신경、척신경、경후신경운동전도속도감만,영중비총신경화정중신경운동전도속도강저검출솔분별위48.6％( 138/248),37.0％(155/419).중독병례자각증상이신경쇠약、지체마목、감각이상위주,신경계통체정중근건반사(79.4％,212/267)、슬반사(49.8％,133/267)양성검출솔교고.심전도ST단개변(T파저평、T파도치、ST단압저)검출솔위19.1％(51/267);고혈압、수축압승고급서장압승고검출솔의차위27.3％( 73/267)、22.5％( 60/267)화21.1％( 59/267).유산탈경매、삼산감유지、저밀도지단백이상양성검출솔교고.남성병례적간접담홍소、직접담홍소、뇨산양성검출솔명현고우녀성,병차뇨소담、간접담홍소양성검출솔수접독공령적연장이축점증가.결론 직업성만성CS2중독주요영향신경계통,대간신공능야유일정적영향.CS2작업인원직업성건강체검중,용신경기-전도사검운동신경손상시,건의수선검사정중운동신경화비총운동신경전도속도.
Objective To analyze the clinical characteristics of 267 cases with occupational chronic carbon disulfide (CS2) poisoning and to provide the basis for revising the items of periodical medical examination of workers occupationally exposed to CS2.Methods The subjects of present study were 267patients with mild CS2 poisoning diagnosed according to "Diagnostic Criteria of Occupational Chronic Carbon Disulfide Poisoning (GBZ4-2002)" from April in 2006 to May in 2010.All patients were from the same chemical fiber factory.When a subject was diagnosed as patient with CS2 poisoning,who should interview with questionnaire which included the illness and occupational history,symptoms,individual habits.The physical examination,nervous test,cardiovascular test,biochemical test and electromyogram were performed.Results The rate of decreased motor conduction velocity was 87.3% (233/267roots).The highest detection rate of slowing conduction velocity was the common peroneal motor nerve which was 48.6% ( 138/248 roots) and the second was median motor nerve with delay rate of 37% ( 155/419 roots).The main symptoms of the patients were neurasthenia,numbness and paresthesia.The rates of abnormal achilles tendon reflex and knee jerk reflex in patients were were 79.4% and 49.8%,respectively.The detected rates of patients with ST-segment changes and hypertension were 19.1% and 27.5%,respectively.The rates of hypertension,systolic pressure and diastolic pressure were 27.3%,22.5% and 21.1%,respectively.The rates of lactate dehydrogenase (LDH),triglycerides (TG) and low density lipoprotein (LDL) were high.The detected rates of urine acid,indirect bilirubin and total bilirubin in male patients were higher than those in female patients.In addition,the abnormal detected rate of urea nitrogen and indirect bilirubin increased with exposure years.Conclusion Occupational chronic CS2 poisoning mainly affects the nervous system,as well as liver and kidney function.Detecting the median and common peroneal motor nerve conduction velocities could be the screening indicators for the peripheral nerve injury induced by CS2 in the occupational exposure population during the periodical occupational medical examinations.
