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目的探讨长期在低浓度混苯作业环境下,作业工人肝损害的超声影像学以及血清生化学变化及其临床意义。方法采用彩色多普勒超声显像仪,选择接触低浓度苯、甲苯和二甲苯(混苯)的作业工人110人(男80人,女30人)作为接触组。另选其他非接触混苯的在年龄、工龄、性别等构成方面无显著差异的人员110人(男72人,女38人)作为对照组。接触组和观察组均进行常规肝脏超声检查,肝中静脉管径及频谱,同时检查肝血清生化学指标。结果混苯接触组B超肝肿大检出率为10.90%,明显高于对照组的2.72%;脂肪肝检出率为16.36%,明显高于对照组的7.27%;肝异常回声检出率为33.63%,明显高于对照组的12.72%;肝中静脉血流频谱异常检出率为19.09%,明显高于对照组的8.18%。以上4组指标差异均有统计学意义(均P<0.05)。肝的血清生化学检查中,接触组的天冬氨酸转氨酶(AST)(15.45%)和丙氨酸转氨酶(ALT)(12.72%)活力升高的检出率明显高于对照组的5.45%和3.63%;差异均有统计学意义(均P<0.05)。结论混苯不仅会造成血液系统损害,也会造成肝脏损害。低浓度混苯作业工人肝声像肝中静脉频谱以及血清生化较对照组均有不同程度损害的改变,早期应用超声检查能更好地发现肝形态学和肝血流动力的变化,而血清生化学检查也可以判断肝脏功能改变,两者相结合诊断肝脏损害有助于早期判断肝脏受损的程度,为混苯作业人员早期发现肝损害、保护机体健康提供依据和方法,有一定临床实用价值。
OBJECTIVE To investigate the long-term ultrasound imaging and serum biochemical changes of hepatic injury in workers exposed to low concentrations of benzene and its clinical significance. Methods A total of 110 workers (80 males and 30 females) exposed to low concentrations of benzene, toluene and xylene (mixed benzene) were selected as the exposure group by color Doppler sonography. 110 other men (72 males and 38 females) of other non-contact mixed benzene with no significant difference in age, length of service and gender were selected as the control group. Both the exposure group and the observation group underwent routine liver ultrasound examination, the diameter and spectrum of the middle hepatic vein, and the liver biochemical indexes. Results The detection rate of B ultrasonography in mixed benzene exposure group was 10.90%, significantly higher than that of control group (2.72%). The detection rate of fatty liver was 16.36%, significantly higher than that of control group (7.27%). The detection rate of abnormal liver echo Was 33.63%, which was significantly higher than that of the control group (12.72%). The detection rate of hepatic vein blood flow anomalies was 19.09%, which was significantly higher than that of the control group (8.18%). The above four groups of indicators were statistically significant (all P <0.05). In the liver biochemical tests, the detection rate of aspartate aminotransferase (AST) (15.45%) and alanine aminotransferase (ALT) (12.72%) in the contact group was significantly higher than that of the control group (5.45% And 3.63%, respectively (all P <0.05). Conclusion Mixed benzene not only causes blood system damage, but also causes liver damage. Low-concentration mixed-benzene workers in the liver of the liver of the spectrum of hepatic vein and serum biochemical changes than the control group have varying degrees of damage changes early detection of liver morphology and liver hemodynamics can be better detected changes in serum creatinine Chemical tests can also determine the liver function changes, the combination of the two to diagnose liver damage help to determine the extent of early liver damage for mixed benzene workers early detection of liver damage, protect the body to provide the basis for health and methods, have some clinical value .