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[肝脏与环境毒物]

[The liver and environmental poisons].

作者信息

Lelbach W K

出版信息

Klin Wochenschr. 1985 Nov 15;63(22):1139-51. doi: 10.1007/BF01740589.

Abstract

For almost a century now numerous examples of acute and subacute hepatic injury from exposure to toxic agents in the occupational or non-occupational environment have been extensively studied and are well documented, but such events are comparatively rare. In contrast, epidemiological data associating exposure to environmental chemicals with chronic liver disease or primary hepatic malignancies in the human is scarce as compared with the vast body of literature concerning chronic pulmonary disease as a consequence of exposure at the workplace. Large-scale industrial production of many newly synthesized organic chemicals began during the period 1930-1940 but it was not until the 1960s that the output increased exponentially. Consequently, the spectrum of environmental influences is gaining increasing complexity since simultaneous or sequential exposure to a variety of pollutants is becoming the rule rather than the exception. Possible interaction or synergism of environmental agents--even of those which in themselves or for their low dosage level may be considered "harmless" - and particularly latency periods of more than one decade further complicate preventive strategies. The liver, as the central site for the biotransformation of xenobiotics, deserves special attention when new chemicals which are to be introduced into the environment are being tested for their potential toxicity, especially since many hepatotoxic agents have been shown to undergo bioactivation in the liver. Currently available information on hepatic injury due to environmental agents is briefly reviewed and comprises solvents and degreasing agents, pesticides, polyhalogenated biphenyls, dioxins and dibenzofuranes, epoxy resin hardeners, vinyl chloride, naturally occurring hepatotoxins in plants and fungi, herbal medicines and traditional remedies and a side-light on the Reye syndrome and the Spanish "toxic oil syndrome".

摘要

近一个世纪以来,职业或非职业环境中接触有毒物质导致急性和亚急性肝损伤的众多案例已得到广泛研究且记录详实,但这类事件相对较少。相比之下,与大量关于工作场所接触导致慢性肺病的文献相比,将接触环境化学物质与人类慢性肝病或原发性肝癌联系起来的流行病学数据却很匮乏。许多新合成有机化学品的大规模工业生产始于1930年至1940年期间,但直到20世纪60年代产量才呈指数级增长。因此,环境影响的范围日益复杂,因为同时或相继接触多种污染物正成为常态而非例外。环境因素之间可能的相互作用或协同作用——即使是那些本身或因其低剂量水平可能被认为“无害”的因素——尤其是超过十年的潜伏期,进一步使预防策略变得复杂。肝脏作为外源性物质生物转化的中心部位,在对即将引入环境的新化学品进行潜在毒性测试时值得特别关注,特别是因为许多肝毒性物质已被证明在肝脏中会发生生物活化。本文简要回顾了目前关于环境因素导致肝损伤的现有信息,包括溶剂和脱脂剂、农药、多氯联苯、二恶英和二苯并呋喃、环氧树脂硬化剂、氯乙烯、植物和真菌中的天然肝毒素、草药和传统药物,以及对瑞氏综合征和西班牙“有毒油综合征”的简要介绍。

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