Ghasemi Hassan, Askari Nayere, Naghizadeh Mohammad Mehdi, Kabudanian Ardestani Susan, Moaiedmohseni Sakine, Vaez Mahdavi Mohammad Reza, Ghazanfari Tooba
Immunoregulation Research Center, Shahed University, Tehran, Iran.
Dept.of Ophthalmology, Shahed University, Tehran, Iran.
Iran J Pathol. 2018 Spring;13(2):157-166. Epub 2018 Jul 17.
BACKGROUND & OBJECTIVE: Many biochemical features of sulfur mustard (SM) intoxication have remained unknown. So far, the direct association between biochemical parameter changes and ocular problems in patients exposed to SM is not evaluated. The current study aimed at evaluating the associations between the ocular findings in patients with SM intoxication and the changes of serum and blood biochemical parameters.
In the current study, 372 patients exposed to SM and 128 matched controls were compared concerning the association between their ocular problems and biochemical parameters. Ocular problems include photophobia, ocular surface discomfort (OSD), etc. Biochemical parameters include uric acid, creatinine (Cr), hematocrit (HCT), total, direct and indirect bilirubin, high-density lipoproteins (HDL), alanine aminotransferase (ALT), calcium (Ca), fasting blood sugar (FBS), mean corpuscular hemoglobin concentration (MCHC), etc.
The SM-exposed group with photophobia, OSD, tearing, blurred vision, abnormal tear status, and slit-lamp findings had significantly higher mean serum and blood levels of uric acid, Cr, HCT, and total and indirect bilirubin than the controls. The SM-exposed group with photophobia, tearing, ocular pain, blurred vision, bulbar conjunctival and limbal abnormalities had significantly higher mean serum and blood levels of HDL, ALT, Ca, FBS, MCHC, and HDL, indirect and total bilirubin, compared to the control group.
The association of photophobia with uric acid, OSD and tearing with Cr, photophobia with HDL, ocular pain with Ca, and blurred vision with FBS may be explained for their known ocular effects in the SM-exposed subjects. SM-induced biochemical changes may intensify the ocular problems induced by the direct effects of SM.
硫芥(SM)中毒的许多生化特征仍不为人知。迄今为止,尚未评估接触SM患者生化参数变化与眼部问题之间的直接关联。本研究旨在评估SM中毒患者的眼部表现与血清及血液生化参数变化之间的关联。
在本研究中,比较了372例接触SM的患者和128例匹配对照者的眼部问题与生化参数之间的关联。眼部问题包括畏光、眼表不适(OSD)等。生化参数包括尿酸、肌酐(Cr)、血细胞比容(HCT)、总胆红素、直接胆红素和间接胆红素、高密度脂蛋白(HDL)、丙氨酸氨基转移酶(ALT)、钙(Ca)、空腹血糖(FBS)、平均红细胞血红蛋白浓度(MCHC)等。
有畏光、OSD、流泪、视力模糊、泪液状态异常和裂隙灯检查异常的SM暴露组,其血清和血液中尿酸、Cr、HCT以及总胆红素和间接胆红素的平均水平显著高于对照组。与对照组相比,有畏光、流泪、眼痛、视力模糊、球结膜和角膜缘异常的SM暴露组,其血清和血液中HDL、ALT、Ca、FBS、MCHC以及HDL、间接胆红素和总胆红素的平均水平显著更高。
畏光与尿酸、OSD和流泪与Cr、畏光与HDL、眼痛与Ca以及视力模糊与FBS之间的关联,可能因其在SM暴露个体中已知的眼部效应而得到解释。SM诱导的生化变化可能会加剧SM直接作用所引发的眼部问题。