Musk A W, Gandevia B
Br J Ind Med. 1976 Aug;33(3):158-65. doi: 10.1136/oem.33.3.158.
Sixty-seven workers in the detergent industry whose exposure to proteolytic enzyme ceased in 1969 have been examined clinically and functionally. By comparison with 42 lightly and moderately exposed subjects, 13 heavily exposed subjects showed significant loss of pulmonary elastic recoil as evidenced by increased lung volumes and increased pulmonary compliance, but there were no differences in airways resistance or other parameters of lung function. No difference was found between the two groups in relation to symptoms on exposure, current exercise tolerance, skin reactivity to the proteolytic enzyme alcalase, trypsin inhibitor capacity, and other features. An increased clinical grade of breathlessness was associated with evidence of airways obstruction, but not of altered elastic recoil. Comparison of the data on lung mechanics with results obtained in 1970 suggests that partial recovery of pulmonary elastic recoil may have occurred in some cases. It is also suggested that diminished elastic recoil, in the absence of impairment of transfer factor at rest, may reflect altered physical properties of the lung fibre network without loss of effective surface area available for gas exchange.
对67名于1969年停止接触蛋白水解酶的洗涤剂行业工人进行了临床和功能检查。与42名轻度和中度接触者相比，13名重度接触者表现出明显的肺弹性回缩力丧失，表现为肺容积增加和肺顺应性增加，但气道阻力或其他肺功能参数没有差异。两组在接触时的症状、当前运动耐力、皮肤对蛋白水解酶碱性蛋白酶的反应性、胰蛋白酶抑制能力及其他特征方面均未发现差异。呼吸急促临床分级增加与气道阻塞证据相关，但与弹性回缩改变无关。将肺力学数据与1970年获得的结果进行比较表明，在某些情况下，肺弹性回缩可能已部分恢复。还表明，在静息时转移因子未受损的情况下，弹性回缩减弱可能反映了肺纤维网络物理性质的改变，而没有可用于气体交换的有效表面积的损失。
