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支气管肺泡灌洗中的石棉小体与肺实质中的石棉小体和石棉纤维的关系

Asbestos bodies in bronchoalveolar lavage in relation to asbestos bodies and asbestos fibres in lung parenchyma.

作者信息

Karjalainen A, Piipari R, Mäntylä T, Mönkkönen M, Nurminen M, Tukiainen P, Vanhala E, Anttila S

机构信息

Finnish Institute of Occupational Health, Helsinki, Finland.

出版信息

Eur Respir J. 1996 May;9(5):1000-5. doi: 10.1183/09031936.96.09051000.

Abstract

In Finland, unlike other countries, anthophyllite asbestos has been widely used due to its domestic production in 1918-1975. In this particular context, the aim of the present study was to analyse the relationship between asbestos bodies (ABs) in bronchoalveolar lavage (BAL) fluid and the concentration of ABs and the different amphibole asbestos fibres in lung tissue. Sixty five BAL lung tissue sample pairs from patients with pulmonary disease were analysed. The concentration of ABs in BAL fluid and lung tissue was determined with optical microscopy, and the concentration, type and dimensions of asbestos fibres in lung tissue with scanning electron microscopy. There was a significant correlation between the concentrations of ABs in BAL fluid and in lung tissue (r = 0.72; p < 0.001), between the concentrations of ABs and amphibole asbestos fibres in lung tissue (r = 0.73; p < 0.001), and between the concentration of ABs in BAL fluid and the concentration of amphibole asbestos fibres in lung tissue (r = 0.64; p < 0.001). In patients who had been exposed mainly to commercial anthophyllite, significantly higher concentrations of ABs were observed per total pulmonary amphibole fibre burden, as compared to patients whose main exposure was to crocidolite/amosite. The anthophyllite fibres in lung tissue were longer than the crocidolite/amosite fibres. The relationship between asbestos body counts in lung tissue and in bronchoalveolar lavage fluid was similar to previous international observations. When using the asbestos body count to predict the underlying total pulmonary amphibole asbestos burden in Finnish patients, however, it should be borne in mind that the relationship between the two parameters seems to be different with anthophyllite as compared to crocidolite/amosite fibres.

摘要

在芬兰,与其他国家不同,叶蛇纹石石棉因其在1918年至1975年的国内产量而被广泛使用。在此特定背景下,本研究的目的是分析支气管肺泡灌洗(BAL)液中的石棉小体(ABs)与ABs浓度以及肺组织中不同闪石类石棉纤维之间的关系。对65例肺部疾病患者的BAL肺组织样本对进行了分析。用光学显微镜测定BAL液和肺组织中ABs的浓度,用扫描电子显微镜测定肺组织中石棉纤维的浓度、类型和尺寸。BAL液和肺组织中ABs的浓度之间存在显著相关性(r = 0.72;p < 0.001),肺组织中ABs与闪石类石棉纤维的浓度之间存在显著相关性(r = 0.73;p < 0.001),BAL液中ABs的浓度与肺组织中闪石类石棉纤维的浓度之间存在显著相关性(r = 0.64;p < 0.001)。与主要接触青石棉/铁石棉的患者相比,主要接触商用叶蛇纹石的患者每总肺闪石纤维负荷中观察到的ABs浓度显著更高。肺组织中的叶蛇纹石纤维比青石棉/铁石棉纤维长。肺组织和支气管肺泡灌洗液中石棉小体计数之间的关系与先前的国际观察结果相似。然而,当使用石棉小体计数来预测芬兰患者潜在的总肺闪石石棉负荷时,应该记住,与青石棉/铁石棉纤维相比,叶蛇纹石的这两个参数之间的关系似乎有所不同。

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