Neri S, Antonelli A, Falaschi F, Boraschi P, Baschieri L
Postgraduate Occupational Medicine School, University of Pisa, Italy.
Occup Environ Med. 1994 Apr;51(4):239-43. doi: 10.1136/oem.51.4.239.
The lungs of 50 symptom free workers exposed to amosite and with normal pulmonary function tests were examined by high resolution computed tomography (HRCT). Twenty five had normal standard chest radiographs whereas the other 25 had radiographs interpreted as near normal (International Labour Office profusion score < 0/1 or suspected pleural plaques). In 13 of the workers the results of HRCT were negative; in 22 pleural plaques were found, in five there was only parenchymal involvement, and 10 had both pleural and parenchymal changes. The mean duration of exposure to amosite was significantly longer for the subjects with parenchymal signs than for those with normal parenchyma and for the workers with pleural plaques than for those with normal pleura and lung parenchyma. The prevalence of identified pleural and parenchymal abnormalities in the 50 workers was also significantly higher than in a reference group without exposure to asbestos. It is concluded that HRCT may detect initial lung and pleural involvement in symptom free workers exposed to amosite and the mean duration of exposure is longer for subjects with parenchymal or pleural involvement.
对50名接触铁石棉且肺功能测试正常的无症状工人的肺部进行了高分辨率计算机断层扫描(HRCT)检查。其中25人标准胸部X光片正常,另外25人的X光片被解读为接近正常(国际劳工组织肺纹理分级<0/1或疑似胸膜斑)。13名工人的HRCT结果为阴性;22人发现有胸膜斑,5人仅有实质受累,10人同时有胸膜和实质改变。有实质体征的受试者接触铁石棉的平均时长显著长于实质正常的受试者,有胸膜斑的工人接触铁石棉的平均时长显著长于胸膜和肺实质正常的工人。这50名工人中已确定的胸膜和实质异常患病率也显著高于未接触石棉的参照组。得出的结论是,HRCT可能检测出接触铁石棉的无症状工人肺部和胸膜的早期受累情况,且有实质或胸膜受累的受试者接触时长更长。