摘要
目的观察职业性铁及其化合物粉尘肺沉着病患者脱离粉尘接触约10年后铁代谢指标的改变情况。方法以22例于2004—2006年误诊为电焊工尘肺的职业性铁及其化合物粉尘肺沉着病患者为研究对象,在其脱离粉尘接触约10年后,对其进行胸部高千伏X射线摄影和计算机断层扫描,检测血清铁代谢指标、血常规和血生化指标。随机抽取6例患者进行遗传性血色病基因检测。根据肺部是否有小阴影分为观察组(13例)和对照组(9例)。结果 22例患者血清铁蛋白(SF)水平中位数为858.2μg/L,超标率为77.3%(17/22),其中铁过载占40.9%(9/22)。血清总铁结合力(TIBC)超标率为22.7%(5/22);血清铁超标率为4.5%(1/22)。观察组SF水平高于对照组(P<0.05)。SF与丙氨酸氨基转移酶(ALT)呈正相关(P<0.05),TIBC与前白蛋白呈正相关(P<0.05),血清铁分别与ALT、天冬氨酸氨基转移酶呈正相关(P<0.05);上述3个铁代谢指标均与血常规指标、血糖、C反应蛋白不相关(P>0.05)。6例患者经遗传性血色病基因检测均可排除遗传性血色病。结论职业性铁及其化合物粉尘肺沉着病患者体内存在铁代谢异常,与铁在肺内沉积有关。
Objective To investigate the changes of iron metabolism index in patients with occupational pulmonary thesaurosis induced by dust of iron or iron compounds after ending iron dust exposure for 10 years. Methods A total of 22 patients with occupational pulmonary thesaurosis induced by dust of iron or iron compounds were selected as study subjects.They were misdiagnosed as electric welder＇s pneumoconiosis in 2004-2006. After ending exposure to iron dust for 10 years,high k V X-ray photography and computed tomography of chest were conducted. Indicators of serum iron metabolism,blood routine and blood biochemical were examined. Six patients were randomly selected to detect genes of hereditary hemochromatosis. The study subjects were divided into observation group（ 13 patients） and control group（ 9 patients）according to the lung examination. Results The median of serum ferritin（ SF） was 858. 2 μg/L. The over standard rate of SF was 77. 3%（ 17/22）,and the iron overload was seen in 40. 9%（ 9/22） of patients. The over standard rate of serum total iron binding capacity（ TIBC） was 22. 7%（ 5/22）. The over standard rate of serum iron was 4. 5%（ 1/22）.The SF level of observation group was higher than that of the control group（ P〈0. 05）. The SF was positively correlated with alanine aminotransferase（ ALT）（ P〈0. 05）. The serum TIBC was positively correlated with prealbumin（ P〈0. 05）. The serum iron were positively correlated with ALT and aspartate aminotansferase respectively（ P〈0. 05）. But the above 3 iron metabolism indices were not correlated with the blood routine indices,blood glucose and C-reactive protein（ P〈0. 05）. The six patients tested for genes of hereditary hemochromatosis were excluded from disease. Conclusion There were iron metabolism abnormalities in patients with occupational pulmonary thesaurosis induced by dust of iron and iron compounds,which is related to the iron deposition in lung.
出处
《中国职业医学》
CAS
北大核心
2017年第5期580-583,共4页
China Occupational Medicine
关键词
铁
粉尘
肺沉着病
铁代谢
肝功能
Iron
Dust
Pulmonary thesaurosis
Iron metabolism
Liver function
