铟化合物致肺部疾病的临床特点  

The clinical features of indium-related lung diseases

作　　者：郭孔荣[1] 刘佳[1] 张静波[1] 孙道远[1] 

机构地区：[1]同济大学附属上海市肺科医院中毒科,上海200433

出　　处：《中华劳动卫生职业病杂志》2015年第8期618-621,共4页Chinese Journal of Industrial Hygiene and Occupational Diseases

基　　金：国家卫生计生委卫生行业科研专项（201402021）;国家职业卫生标准（201408）;上海市三年公共卫生行动计划（20110101）

摘　　要：目的探讨铟化合物所致肺部疾病的临床特点。方法通过检索中文数据库和Pubmed，Embase，Web of Science数据库收集1998年1月至2014年4月关于铟化合物所致肺部疾病的研究资料，对报道的临床病例及有关职业暴露情况、实验资料进行分析总结。结果1998至2010年3月共报道了10例铟化合物所致肺部疾病，日本报道了7例铟化合物所致问质性肺部疾病，美国报道2例铟化合物所致肺泡蛋白沉着症，中国报道了1例铟化合物所致肺泡蛋白沉着症。患者发病前均接触氧化铟锡（ITO），工龄9个月至20年；8例有血清铟浓度增高，检测值为40～290μg／L；诊断为间质性肺炎的潜伏期为2～14年，诊断为肺泡蛋白沉着症的潜伏期6～14个月；10例患者中有8例胸部CT提示两肺广泛或局部毛玻璃影，其中3例同时伴小叶中心结节；8例检测肺功能的患者仅1例正常。诊断间质性肺炎者中4例发现肺泡内有胆固醇碎片，3例有巨噬细胞吞噬颗粒，经X线能量散射分析仪检测发现颗粒含铟、锡成分。6例描述预后的患者中3例死亡。结论职业暴露铟化合物可引起不同的肺部疾病，表现为问质性肺炎或肺泡蛋白沉着症，且预后多不良。车间环境中铟浓度、血清中铟浓度与所患疾病之间的关系尚不明确。Objective To discuss the clinical features of Indium-related lung diseases. Methods We searched database of Chinese and Pubmed, Embase,Web of Science to collect research data of indium-related lung diseases from Jan. 1998 to Aprl. 2014. Case reports, exposure histories and lab results were analysed and summarized. Results 1998 to Mar 2010, ten cases of indium-related lung diseases were published. Seven cases of interstitial pneumonia were reported in Japan, two cases of pulmonary alveolar proteinosis （PAP） were reported in the USA and one case of PAP reported in China. Chest computer tomography （CT） showed diffuse or local ground glass appearance （GGA） in 8 cases ,3 of which also showed centrilobular nodules; Pulmonary function test were normal only in one out of 8 cases. Cholesterol clefts were found in 4 cases of interstitial pneumonia. 3 cases died among 6 cases who were followed-up. Conclusions Occupational exposure to indium compounds are contributory to different pulmonary diseases, which are composed of interstitial pneumonia and pulmonary alveolar proteinosis .The relationships between In-C, In-S and these pulmonary diseases are unclear.

关 键 词：氧化铟锡 职业暴露 肺疾病 间质性 肺泡蛋白沉着症 

分 类 号：R135.2[医药卫生—劳动卫生]