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[油症(多氯联苯中毒)的临床特征与发病机制]

[Clinical features and pathogenesis of Yusho (PCB poisoning)].

作者信息

Asahi M

机构信息

Department of Dermatology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.

出版信息

J UOEH. 1993 Mar 1;15(1):1-11. doi: 10.7888/juoeh.15.1.

Abstract

The occurrence and progress of Yusho (PCB mass poisoning) is briefly described. Various investigative studies on Yusho are also briefly reviewed. Yusho occurred in the northern district of Kyushu Island in 1968. A specific product of rice oil used for food was accidentally contaminated with PCB during its manufacturing process and consequently, the customers who ate it showed severe intoxication symptoms. Major clinical symptoms of Yusho were acneiform eruptions and circumscribed pigmentation. These skin and mucous membrane eruptions, because of their appearance, caused severe mental suffering for the patients. The government-authorized patients amounted to 1,860. These symptoms have gradually declined with the passing of years and presently the principal clinical problems are only various subjective complaints. At first, it was naturally thought that the causative agent of Yusho was PCB (Kanechlor 400) itself. However, it was found later that the causative rice oil contained PCDF (polychlorodibenzofuran) and PCQ (polychloroquaterphenyl) which were proved to be formed during the heating process used in the deodorization of the oil. PCDFs show, in animal studies, a high toxicity and therefore its role for the pathogenesis of Yusho is seriously evaluated in spite of its rather small contaminating amount. On the other hand, PCQs are recognized as the specific marker of Yusho, since almost no PCQ is a general environmental pollution substance.

摘要

本文简要描述了油症(多氯联苯大规模中毒)的发生及发展过程。同时也简要回顾了关于油症的各项调查研究。1968年,油症在九州岛北部地区发生。一种用于食品的米糠油在生产过程中意外被多氯联苯污染,食用该米糠油的消费者出现了严重的中毒症状。油症的主要临床症状为痤疮样皮疹和局限性色素沉着。这些皮肤和黏膜疹因其外观给患者带来了极大的精神痛苦。经政府认定的患者达1860人。随着时间推移,这些症状逐渐减轻,目前主要的临床问题仅是各种主观不适。起初,人们自然认为油症的致病因子是多氯联苯(氯丹400)本身。然而,后来发现致病的米糠油中含有多氯二苯并呋喃(PCDF)和多氯四联苯(PCQ),事实证明它们是在油类脱臭过程的加热环节中形成的。在动物研究中,多氯二苯并呋喃表现出高毒性,因此尽管其污染量相对较小,但仍对其在油症发病机制中的作用进行了严格评估。另一方面,多氯四联苯被视为油症的特异性标志物,因为几乎没有多氯四联苯是常见的环境污染物质。

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