论文部分内容阅读
本文报告两例从事假牙制作工的尘肺。病例1,男,49岁。病人常规X线胸片检查发现两肺上叶弥漫性网状结节阴影,两肺尖胸膜增厚。病人主要从事假牙部件的铸模、切削和刨光的工作,工龄31年,接触硅、碳化硅、石棉、铬—钴—钼合金等粉尘,未发现接触铍。病人物理、生化、血液学以及肺功能检查均正常。支气管肺泡灌洗液(BALF)细胞学检查,细胞数增加,其中主要是中性白细胞。肺活检可见分布不均的肺内纤维化、和明显的肺间质纤维化。一些肺泡扩张,衬以化生的立方上皮,肺泡腔内充满吞噬尘粒的巨噬细胞。这些尘粒不透明有强烈的折光性及金属光泽。在一些纤维化处可见粉尘、含铁小体及饱噬尘粒的巨噬细胞,并有少量多核细胞及中度的淋巴细胞浸润。病人停止工作1年后,做第二次BALF和胸片检查,显示病情有所发展。两肺上叶回缩,肺功能明显减退。病例2,女,30岁。因干咳就诊。她从1972年到1979年一直在牙科实验室半日工作,主要从事假牙部件的清砂,工作中接触铬—钴—钼合金粉尘。不接触石棉和铍。病人的物理、生化、血液学及肺功能检查均正常。胸部X线显示肺上叶弥漫性网状结节影。纤维支气管镜肺活检可见肺
This article reports two cases of pneumoconiosis engaged in dentures. Case 1, male, 49 years old. The patient’s routine X-ray examination revealed diffuse reticular nodules in the upper lobe of both lungs and thickened pleura in both lungs. The patient was mainly engaged in the casting, cutting and planing work of dental prostheses. He was 31 years of service and found no contact with beryllium when exposed to dust such as silicon, silicon carbide, asbestos, chromium-cobalt-molybdenum alloy. The patient’s physical, biochemical, hematological and pulmonary function tests were normal. Bronchoalveolar lavage fluid (BALF) cytology, cell number increased, mainly neutrophils. Pulmonary biopsy showed uneven distribution of intrapulmonary fibrosis, and significant pulmonary fibrosis. Some alveolar dilatation lined with metaplastic cubic epithelium, alveolar cavity filled with phagocytic particles of macrophages. These dust particles are opaque with strong refraction and metallic luster. In some fibrosis visible dust, iron bodies and phagocytic particles of macrophages, and a small amount of multi-nuclear cells and moderate infiltration of lymphocytes. One year after the patient stopped working, a second BALF and chest X-ray examination were performed, indicating that the condition had developed. Upper lung retraction, pulmonary function was significantly reduced. Case 2, female, 30 years old. Due to dry cough treatment. She worked half-day at a dental laboratory from 1972 to 1979 and was primarily involved in sanding dentures and exposed chromium-cobalt-molybdenum alloy dust during her work. Do not touch asbestos and beryllium. The patient’s physical, biochemical, hematological and pulmonary function tests were normal. Chest X-ray showed diffuse reticular nodules in the lung. Fiberoptic bronchoscopy lung biopsy can be seen in the lungs