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杨大平, 张爱华, 李军, 杨光红, 黄晓欣, 董学新, 罗鹏, 张碧霞. 燃煤型污染砷中毒与肝损害关系[J]. 中国公共卫生, 2009, 25(9): 1140-1141. DOI: 10.11847/zgggws2009-25-09-64
引用本文: 杨大平, 张爱华, 李军, 杨光红, 黄晓欣, 董学新, 罗鹏, 张碧霞. 燃煤型污染砷中毒与肝损害关系[J]. 中国公共卫生, 2009, 25(9): 1140-1141. DOI: 10.11847/zgggws2009-25-09-64
YANG Da-ping, ZHANG Ai-hua, LI Jun, . Relationship between arsenism induced by arsenic-coal burning and liver dysfunction[J]. Chinese Journal of Public Health, 2009, 25(9): 1140-1141. DOI: 10.11847/zgggws2009-25-09-64
Citation: YANG Da-ping, ZHANG Ai-hua, LI Jun, . Relationship between arsenism induced by arsenic-coal burning and liver dysfunction[J]. Chinese Journal of Public Health, 2009, 25(9): 1140-1141. DOI: 10.11847/zgggws2009-25-09-64

燃煤型污染砷中毒与肝损害关系

Relationship between arsenism induced by arsenic-coal burning and liver dysfunction

  • 摘要: 目的 探讨燃煤型污染砷中毒与肝损害的关系,为砷致肝损害的"三早预防"提供依据.方法 采用临床内科、影像学、病理学及生物化学方法对燃煤型污染砷中毒病区砷暴露人群进行临床症状体征、肝脏B超、病理形态学检查及血清学肝损害指标检测.结果 砷暴露者有不同程度的消化系统主观症状;轻、中、重度组砷中毒患者的B超异常率分别为12%,34%和64%(P<0.01);砷中毒患者肝脏病理学改变以肝组织纤维增生改变最为明显.血清学检查发现:谷胱甘肽硫转移酶(GSTs)(20.42±11.10)U/L,羟脯氨酸(Hyp)(29.5±7.3)μg/mL,血清透明质酸(HA)(68.48±51.80)μg/L,轻、中、重度组皆明显高于对照组(P<0.01);总胆汁酸(6.84±4.45)μmol/L、γ-谷氨酰转肽酶(49.71±28.50)U/L,Ⅲ型前胶原(92.01±43.77)μg/L和Ⅳ型胶原(89.33±14.41)μg/L,在中、重度组明显高于对照组(P<0.01).结论 GSTs、Hyp、HA的联合检测对早期发现和诊断砷所致肝细胞损害及肝纤维化有重要参考价值;肝脏B超检查及选择性监测上述指标,对判断肝损害的发生发展及针对性治疗有实际意义.

     

    Abstract: Objective To explore the relationship between a rsenism induced by a rsenic-coal burning and liver dysfunction in order to provide evidence for early prevention of liver damage.Methods Physical check-up,B-typ eultrasonog raphic and pathological examination of liver were conducted to detect liver dysfunction among the population exposed to coal burning arsenic pollution in endemic area.Results Different symptoms existed among the population.A bnormal rates of B-type ultrasonog raphic examination of liver were 12%,34%,and 64% for subjects with mild,medium,and severe a rsenism(P<0.01).Main pathological change of arsenism patients was liver fibrosis.Glutathione S-transferase(GSTs),hydroxypro line(Hyp)and hyaluronic acid(HA)were significantly higher in all a rsenism groups than that of in the control group(P<0.01).Ttotal bile acid(TBA),γ-glutamyl transpeptidase(γ-GT),procollagen typeⅢ(PCⅢ),and collagen type Ⅳ(ⅣC)were obviously increased in medium and severe arsenism groups than that of in the control group(P<0.01).Conclusion Detections of GSTs,Hyp and HA are of important reference value for early finding and diagnosis of arsen ic-induced liver cell in jury and fibrosis.B-type ultrasonographic examination of liver and selective laboratory tests have practical significance for diagnosis and treatment of liver dysfunction.

     

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