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[罗兹诺费职业医学研究所诊断的患者中,职业性接触二异氰酸酯长时间停止情况下诊断方法的实际价值]

[The real value of diagnostic methods in case of long time of cessation of occupational exposure to diisocyanates among patients diagnosed in the nofer institute of occupational medicine in Łodź].

作者信息

Swierczyńska-Machura Dominika, Walusiak-Skorupa Jolanta, Wiszniewska Marta, Lipińska-Ojrzanowska Agnieszka, Wittczak Tomasz, Dudek Wojciech, Pałczyński Cezary

机构信息

Instytut Medycyny Pracy.

出版信息

Med Pr. 2011;62(6):567-77.

Abstract

BACKGROUND

The aim of the study was to analyze the data obtained during the diagnostic process and their real values in the final diagnosis of patients exposed to diisocyanates amd suspected of occupational allergic disease of the respiratory system The patients have been hospitalized in the Nofer Institute of Occupational Medicine over recent 11 years.

MATERIAL AND METHODS

In 1999-2009 we hospitalized 37 patients exposed to diisocyanates and suspected of occupational asthma.

RESULTS

Test results of 37 patients were analyzed. The patients were divided into three groups of those with diagnosed occupational asthma, with diagnosed non-occupational asthma and those without any allergic airway disease. 40.0% of patients with occupational asthma, 64.3% of patients with non-occupational asthma and 15.4% of patients without any allergic disease were sensitized to at least one of common allergens. We did not find any specific IgE to diisocyanates. Specific challenge tests were performed in all the 37 subjects. We observed positive results of SIT with diisocyanates in 10 patients.

CONCLUSIONS

Only specific challenge test with diisocyanates showed the real diagnostic value in case of a 7.5-year cessation of exposure. Determination of serum specific IgE to diisocyanates does not seem to be of clinical value in the diagnosis of diisocyanate-induced asthma in case of a 7.5 year cessation of exposure. Atopy is not the risk factor in diisocyanate-induced asthma.

摘要

背景

本研究旨在分析诊断过程中获得的数据及其在二异氰酸酯暴露且疑似职业性呼吸系统过敏性疾病患者最终诊断中的实际价值。近11年来,这些患者均在诺费尔职业医学研究所住院治疗。

材料与方法

1999年至2009年期间,我们收治了37名接触二异氰酸酯且疑似职业性哮喘的患者。

结果

对37例患者的检测结果进行了分析。这些患者被分为三组,分别是诊断为职业性哮喘的患者、诊断为非职业性哮喘的患者以及无任何过敏性气道疾病的患者。40.0%的职业性哮喘患者、64.3%的非职业性哮喘患者和15.4%的无任何过敏性疾病的患者对至少一种常见变应原敏感。我们未发现针对二异氰酸酯的特异性IgE。对所有37名受试者均进行了特异性激发试验。我们观察到10例患者二异氰酸酯特异性免疫治疗(SIT)结果呈阳性。

结论

在接触停止7.5年后,仅二异氰酸酯特异性激发试验显示出实际诊断价值。在接触停止7.5年后,测定血清中二异氰酸酯特异性IgE在诊断二异氰酸酯诱发的哮喘方面似乎没有临床价值。特应性不是二异氰酸酯诱发哮喘的危险因素。

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