接触聚氯乙烯粉尘10年后出现的尘肺病和系统性硬化症。

Studnicka M J, Menzinger G, Drlicek M, Maruna H, Neumann M G

First Internal Department, Centre for Pulmonary Disease, Vienna, Austria.

Thorax. 1995 May;50(5):583-5; discussion 589. doi: 10.1136/thx.50.5.583.

The case history is presented of a 58 year old man who was exposed to thermoplastic dusts, mainly polyvinyl chloride (PVC), for 10 years. Radiography and high resolution computed tomographic scans of the lungs suggested both pneumoconiotic and scleroderma-like lesions. Transbronchial biopsy revealed foreign body granulomas with macrophages laden with birefringent inclusions which ultrastructurally resembled PVC dust. Biopsy samples of thickened skin showed histological evidence of extensive fibrosis. During follow up Raynaud's phenomenon and oesophageal involvement developed. The antinuclear antibody titre was 1:640, and the Sc1-70 subset was positive. It is concluded that exposure to PVC dust may cause pneumoconiosis and secondary systemic sclerosis.

本文报告了一名58岁男性的病例，该患者接触热塑性塑料粉尘（主要是聚氯乙烯（PVC））达10年之久。肺部的X线摄影和高分辨率计算机断层扫描显示出尘肺样和硬皮病样病变。经支气管活检发现异物肉芽肿，巨噬细胞内充满双折射包涵体，超微结构上类似于PVC粉尘。增厚皮肤的活检样本显示出广泛纤维化的组织学证据。在随访期间，出现了雷诺现象和食管受累。抗核抗体滴度为1:640，Sc1-70亚组呈阳性。结论是，接触PVC粉尘可能导致尘肺和继发性系统性硬化症。