Cordasco E M, Demeter S L, Kerkay J, Van Ordstrand H S, Lucas E V, Chen T, Golish J A
Chest. 1980 Dec;78(6):828-34. doi: 10.1378/chest.78.6.828.
Newer varieties of occupational lung diseases primarily due to the vast increase in industrial technology have been reported recently. Preeminent among such newer agents are vinyl chloride (VC) and polyvinyl chloride. Very few cases have been reported, in Europe only, with descriptive histopathologic changes. To our knowledge, no pathologic studies of VC exposure have been described in the American literature. The biopsy abnormalities in our patients disclosed desquamation of alveolar macrophages into the alveolar lumina and minor interstitial and alveolar inflammatory changes. Pulmonary function abnormalities included restrictive insufficiency. Preventive therapy consists of the avoidance of further exposures, frequent industrial hygiene monitoring, and total avoidance of tobacco smoke, as well as associated atmospheric pollutants. Thus far, none of these patients has exhibited evidence of pulmonary neoplasms. All three patients survived their occupational injuries, and two are still disabled to varying degrees. Urine and blood levels of phthalic acid derivatives were elevated in two patients, the exact significance of which is not fully known. It probably represents a toxicologic response, but must be further pursued before conclusions can be reached.
近期有报道称，由于工业技术的大幅提升，出现了一些新型职业性肺病。这类新型致病因素中最突出的是氯乙烯（VC）和聚氯乙烯。目前仅在欧洲报道了极少数病例，并伴有描述性组织病理学变化。据我们所知，美国文献中尚未描述过关于VC暴露的病理学研究。我们患者的活检异常表现为肺泡巨噬细胞脱屑进入肺泡腔，以及轻微的间质和肺泡炎症变化。肺功能异常包括限制性通气不足。预防性治疗包括避免进一步接触、定期进行工业卫生监测、完全避免吸烟以及相关的大气污染物。到目前为止，这些患者均未表现出肺部肿瘤的迹象。所有三名患者均从职业性损伤中存活下来，其中两名仍有不同程度的残疾。两名患者的尿液和血液中邻苯二甲酸衍生物水平升高，其确切意义尚不完全清楚。这可能代表一种毒理学反应，但在得出结论之前必须进一步研究。
