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职业接触大多数现代卤代麻醉剂和一氧化二氮的医师的肝毒性和神经内分泌效应。

Hepatotoxic and neuroendocrine effects in physicians occupationally exposed to most modern halogenated anesthetics and nitrous oxide.

机构信息

Department of Anesthesiology, Medical School, São Paulo State University - UNESP, Botucatu, Brazil.

Department of Anesthesiology, Medical School, São Paulo State University - UNESP, Botucatu, Brazil.

出版信息

Environ Toxicol Pharmacol. 2021 Jan;81:103515. doi: 10.1016/j.etap.2020.103515. Epub 2020 Oct 18.

Abstract

The lack of data on hepatic and hormonal markers for occupational exposure to most modern halogenated anesthetics has stimulated our research, which assessed liver enzymes, high-sensitivity C-reactive protein (hs-CRP) and neuroendocrine response. The study investigated 106 physicians who were categorized in an exposed group (primarily exposed to isoflurane and sevoflurane and less to desflurane and nitrous oxide) as well as as a control group. Anesthetic air monitoring was performed, and biological samples were analyzed for the most important liver enzymes, hs-CRP, adrenocorticotrophic hormone, cortisol and prolactin. No biomarkers were significantly different between the groups. Exposed males showed significant increases in cortisol and prolactin compared to unexposed males. However, values were within the reference ranges, and 22 % of exposed males versus 5 % of unexposed males exhibited higher prolactin values above the reference range. This study suggests that occupational exposure to the most commonly used inhalational anesthetics is not associated with hepatotoxicity or neurohormonal changes.

摘要

由于缺乏关于大多数现代卤代麻醉剂职业暴露的肝脏和激素标志物的数据,我们开展了这项研究,评估了肝酶、高敏 C 反应蛋白(hs-CRP)和神经内分泌反应。该研究调查了 106 名医生,他们分为暴露组(主要接触异氟烷和七氟烷,较少接触地氟烷和氧化亚氮)和对照组。进行了麻醉空气监测,并对最重要的肝酶、hs-CRP、促肾上腺皮质激素、皮质醇和催乳素进行了生物样本分析。两组之间没有明显差异的生物标志物。与未暴露的男性相比,暴露的男性的皮质醇和催乳素显著增加。然而,这些值都在参考范围内,暴露组的 22%男性与未暴露组的 5%男性的催乳素值高于参考范围。本研究表明,职业接触最常用的吸入性麻醉剂与肝毒性或神经激素变化无关。

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