Ghanei M, Adibi I, Farhat F, Aslani J
Baqiyatallah Medical Sciences University, Chemical injuries research center, Tehran, Islamic Republic of Iran.
Chron Respir Dis. 2008;5(2):95-100. doi: 10.1177/1479972307087191.
The association between severity of exposure to sulfur mustard (SM) and late respiratory complications is not clear. The aim of this study was to determine the presence of late pulmonary complications in patients with mild, moderate, and severe initial symptoms of sulfur mustard exposure. This was a retrospective cohort study on patients with mild, moderate, and severe initial symptoms of sulfur mustard exposure (during 1983-1988) in Baqyatallah University of medical sciences (2004-2005). The 'mild' group (n = 115) had no early symptom at the time of exposure. The 'moderate' group (n = 273) had early symptoms after exposure and were not hospitalized for that reason. The 'severe' group (n = 215) had early symptoms and had been hospitalized accordingly. Pulmonary function tests and high-resolution computed tomography of the chest were performed. The chi-square test was used for data analysis. The severe and moderate groups had a similar frequency of obstructive pattern (21%), whereas only one patient in the mild group showed this pattern. Air trapping did not significantly differ between groups. In the mild group, 74.8% (n = 86) showed significant air trapping, whereas it was 62.3% (n = 170) in moderate and 67.0% (n = 144) in severe groups (P = 0.057). Moderate and severe exposure to sulfur mustard causes an equal risk of late pulmonary complications, while mild exposure has lesser risk. Bronchiolitis obliterans is the main underlying respiratory consequence of sulfur mustard exposures and may relate to host factors rather than to severity of early symptoms.
硫芥（SM）暴露的严重程度与晚期呼吸系统并发症之间的关联尚不清楚。本研究的目的是确定硫芥暴露初期症状为轻度、中度和重度的患者中晚期肺部并发症的情况。这是一项对巴基耶塔拉医科大学（2004 - 2005年）中硫芥暴露初期症状为轻度、中度和重度（1983 - 1988年期间）患者的回顾性队列研究。“轻度”组（n = 115）在暴露时无早期症状。“中度”组（n = 273）暴露后有早期症状，但未因此住院。“重度”组（n = 215）有早期症状并因此住院。进行了肺功能测试和胸部高分辨率计算机断层扫描。采用卡方检验进行数据分析。重度组和中度组的阻塞性模式频率相似（21%），而轻度组仅有1例出现这种模式。各组间空气潴留情况无显著差异。轻度组中，74.8%（n = 86）显示有显著空气潴留，中度组为62.3%（n = 170），重度组为67.0%（n = 144）（P = 0.057）。中度和重度硫芥暴露导致晚期肺部并发症的风险相同，而轻度暴露风险较小。闭塞性细支气管炎是硫芥暴露的主要潜在呼吸后果，可能与宿主因素有关，而非早期症状的严重程度。
