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在一家医院肿瘤病房负责为患者调配细胞抑制剂的三名护士工作若干年后(6～16年),发生了不可恢复性肝损害。 这三名护士所调配的细胞抑制药物为博莱霉素(BLM)、长春新碱(VCR)、环磷酰胺(代B—518)、阿霉素(ADM)及氨甲蝶呤(MTX)等。三人均无吸烟或大量饮酒史。其中两人出现持续性头痛,一人出现神经性肌萎缩。实验室检查表明:三人的血清转氨酶、碱性磷酸酶及肝微粒体酶活性均增高。尿试验诱变性增高,染色体裂隙及姊妹染色单体互换(SCE)频率增加。肝活检显示:一人肝门脉区弥漫性坏死;两人肝纤维变性脂肪积聚。当
After several years (six to 16 years) of working with three nurses who were assigned to administer cytostatics to patients in a hospital oncology ward, non-recoverable liver damage occurred. The cytokines used by these three nurses were bleomycin (BLM), vincristine (VCR), cyclophosphamide (B-518), doxorubicin (ADM) and methotrexate (MTX) Wait. All three have no history of smoking or heavy drinking. Two of them experienced persistent headache and one had neuromuscular atrophy. Laboratory tests showed that: three of the serum aminotransferase, alkaline phosphatase and liver microsomal enzyme activity were increased. Urine test mutagenicity increased, chromosome fissures and sister chromatid exchange (SCE) frequency increased. Liver biopsy showed diffuse necrosis of one human portal vein and two liver fibrosis fat accumulation. when