环境石棉材料污染与胸膜斑的关系：CT检出结果分析  

Correlation of asbestos-contaminated environment with pleural plaque: Analysis of CT detection

作　　者：石逸杰[1] 张殿平[1] 张东坡[2] 曾林群[1] 

机构地区：[1]北京市通州区潞河医院放射科,北京市101149 [2]北京市垂杨柳医院放射科,北京市100022

出　　处：《中国组织工程研究与临床康复》2008年第1期134-137,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：目的:北京市通州区在20世纪50年代末至60年代中是石棉材料产品加工密集区,职业性石棉材料对从业者身体健康状况的影响受到政府和社会的重视与关心,而无职业性石棉材料加工从业史的环境石棉材料污染接触人群的胸部异常情况是否也与环境石棉材料污染相关?通过CT检测回顾性分析环境石棉材料污染与胸膜斑的关系。方法:选取2004-05/2005-06北京市通州区潞河医院放射科CT检出的胸膜斑病例,本人无职业性石棉材料加工从业史35例,详细询问和记录每例的职业史和生活史,受试者对此调查内容均知情同意。使用GEProspeedFast和PQ5000CT机进行常规胸部扫描和大间隔高分辨率CT扫描。参照Meirelles提出的高分辨率CT对胸膜斑量化标准进行评分。肺内损害积分以观察到小叶中心结节、胸膜下间隔线、肺实质带及蜂窝影为积分依据。以60周岁为界将患者分为老年组与中年组;再依据患者接触石棉材料环境程度将患者分为较密切接触组与非密切接触组,分别统计胸膜斑得分和肺内损害积分。结果:①34例可以追问到间接石棉材料接触史,另1例于1960年前后在石棉材料加工密集区居住。②胸壁胸膜斑总分为2432分,平均69.49分/例;左膈胸膜斑平均比值0.21,右膈胸膜斑平均比值0.25;肺内损害积分1.49分/例;出现纵隔胸膜斑17例。③老年组与中年组间胸壁胸膜斑得分比较差异有显著性(P<0.05),其余各组间差异无显著性(P>0.05)。结论:胸部低剂量CT扫描成本低、剂量小,对胸膜斑的检出率显著高于胸片,提高了胸膜斑的检出率,有利于对环境石棉材料污染接触人群胸膜斑的发病情况的筛查及动态监测。AIM： From the late 1950s to the mid-1960s, Tongzhou, a district in Beijing, was a concentrated area of asbestos material manufacturing, and the physical conditions of occupational asbestos workers have received considerable attentions from both the government and the society. However, is the abnormality manifested in the chests of those never employed in the asbestos material industry but exposed to asbestos material pollution, related to the asbestos-contaminated environment. This study conducted a retrospective analysis to explore the correlation between asbestos-contaminated environment and pleural plaque by CT detection. METHODS： Cases with pleural plaque detected by CT from May 2004 to June 2005 in Radiology Department of Lnhe Hospital in Tongzhou District, were adopted in this study, from whom non-occupational asbestos-exposed group （35 cases） were chosen, then their occupation and life history were inquired in detail and noted. Informed consents to the investigation were obtained from all the cases. GE Prospeed Fast and PQ5000 CT were used for general bosom scan and big-interval high-resolution CT scan. We used high-resolution CT for grading these cases according to pleural plaque standard of Meirelles. The lung lesion integral was rooted in centrilobular nodule, subpleural septal line, lung parenchyma chord and honeycomb shadow. Boundary as 60 years, these cases were divided into old-age group and middle-age group; and according to the extent of asbestos material environment these cases contacted, they were distinguished obvious osculation group from unobvious osculation group. Pleural plaque score and lung lesion integral were measured statistically. RESULTS： （1）There were 34 cases who had indirect history of asbestos exposure by insistent questions, and 1 case lived in the area where asbestos was processed around 1960.（2）The total score of pleural plaque in chest wall was 2 432, with a mean of 69.49 in each case; the mean ratio of left diaphragm pleural plaque was 0.21 and the mean rat

关 键 词：胸膜斑 环境石棉污染 CT 低剂量CT扫描 

分 类 号：R318.08[医药卫生—生物医学工程]