锡冶炼生产性粉尘致大鼠肺组织损伤的实验研究

发布时间：2018-02-28 10:20

本文关键词： 锡冶炼工人接尘工龄尘肺锡尘肺纤维化　出处：《广西医科大学》2012年硕士论文　论文类型：学位论文

【摘要】：目的：了解锡冶炼工人尘肺病的发病情况,并分析其与工人接尘工龄之间的相关关系；探讨锡冶炼生产性粉尘对肺组织的损伤及其程度,推测接尘工人引起尘肺病的可能性。方法：(1)采用横断面调查研究方法,收集广西某冶炼厂锡冶炼车间所有在岗的冶炼工人2010年的体格检查资料,以及其中的尘肺病患者的全部诊断资料。运用现时寿命表法计算患者工龄累积发病概率和工人尘肺病累积患病率,应用SPSS16.0统计软件进行接尘工龄与工人累积患病率的相关回归分析。 (2)收集广西某冶炼厂锡冶炼车间粗炼车间和精炼车间的呼吸带高度自然沉降的生产性粉尘,筛选粒度5μ m的呼吸性粉尘,并测定其分散度及游离二氧化硅含量,生理盐水配制成50mg/ml的浓度进行实验。选择SPF级SD大鼠,随机分成粗炼车间锡冶炼粉尘组、精炼车间锡冶炼粉尘组及标准石英粉尘阳性对照组和生理盐水阴性对照组,以1ml/只的剂量通过非暴露式气管内染尘方法对大鼠进行染尘,观察第30天和第90天的肺组织病理切片,并测量大鼠体重及全肺湿重,计算肺脏器系数,应用SPSS16.0统计软件分析各组间肺脏器系数的差异。结果：(1)一般情况及尘肺病发病情况：锡冶炼车间共385名冶炼工人,其中男性354人,女性31人,年龄在19-56岁；总工龄在0.17-38.00年,平均总工龄16.51年；接尘工龄0.17-36.00年,平均接尘工龄15.62年。385名锡冶炼工中有9例确诊为尘肺病患者,均为男性,检出率为2.34%,患者确诊为尘肺病时的年龄在34～55(39.0±5.1)岁,接尘工龄9-18(15.6±3.1)年。 (2)患者工龄累积发病率：该厂锡冶炼工人尘肺病患者发病的接尘工龄在9-18年,发病率随着接尘工龄的增加逐渐升高,接尘工龄在13-18年发病率迅速升高。 (3)尘肺病累积患病率及其与接尘工龄的相关分析：锡冶炼生产工人中尘肺病的患病人数集中在接尘工龄9-23年间,接尘工龄与尘肺病累积患病率之间呈高度正相关[相关系数(r)=0.933,P0.05],回归方程为y=O.003x-0.012。 (4)锡冶炼车间生产性粉尘游离二氧化硅含量：粗炼车间粉尘游离氧化硅含最为53.19%,精炼车间粉尘为44.25%：经筛选后两车间粉尘粒度5μ m的尘粒所占百分数均在90%以上。 (5)大鼠肺脏器系数比较：染尘后第30天,粗炼车间粉尘组与阴性对照组和阳性对照组之间的差异均有统计学意义(p0.05),精炼车间粉尘组与阴性对照组之间的差异有统计学意义(p0.05),而与阳性对照组之间的差异无统计学意义(p0.05)；第90天,粗炼车间粉尘组与阴性对照组之间的差异无统计学意义(p0.05),而与阳性对照组之间的差异有统计学意义(p0.05),精炼车间粉尘组与阴性对照组和阳性对照组之间的差异均有统计学意义(p0.05)。 (6)肺组织病理观察：肉眼观察,30天时,粗炼组两肺组织呈淡红色,表面可见散在针头大小的中心为暗黑色、周围灰白色斑点,精炼组可见散在中心为灰黑色、周围灰白色斑点,形状不规则；90天时,粗炼组部分大鼠肺组织呈灰白色实变状,表面可见散在灰白色斑点,质地较韧,精炼组部分大鼠肺组织表面呈灰黑色实变状,尚有灰白色斑点。镜下观察,两组均可见散在粉尘颗粒沉着和尘灶形成,多位于细支气管、终末支气管、肺泡管周围,尘灶内可见巨噬细胞、纤维母细胞、中性粒细胞和淋巴细胞反应,均发生炎症反应,第90天时,粗炼组可见有尘-炎性肉芽肿形成。结论：(1)锡冶炼工人接尘工龄与尘肺病累积患病率之间关系密切,在该厂现有劳动条件下,若想把尘肺病的患病率控制在1%左右,工人的接尘工龄期限以不超过7年为宜。 (2)锡冶炼粗炼车间和精炼车间生产性粉尘致染尘动物第30天和第90天的肺组织病理变化表现为炎症反应、粉尘颗粒沉着和尘灶形成,尘灶内可见少量巨噬细胞、淋巴细胞增生,粗炼车间粉尘还可见尘炎性肉芽肿形成,尘肺早期病变形成,但由于观察时间较短,尚需观察更长时间或做进一步深入研究。
[Abstract]:Objective: to understand the incidence of pneumoconiosis in tin smelting workers, and analyze the relationship between them and the workers' age of dust exposure, explore the damage and degree of tin smelting dust on lung tissue, and predict the possibility of pneumoconiosis caused by dust workers.
Methods: (1) using the method of cross-sectional study, physical examination data collected in Guangxi smelter tin smelting workshop all in smelting workers in 2010, and the patients with pneumoconiosis diagnosis. All the data using current life table method with seniority cumulative incidence and workers pneumoconiosis cumulative prevalence rate, using SPSS16.0 statistical software by regression analysis of the dust exposed workers with cumulative prevalence.
(2) the collection of Guangxi smelter smelting workshop tin smelting workshop and refining plant breathing zone height natural sedimentation dust production, screening of particle size of 5 mu m respirable dust, and determination of the dispersion and free silica content, physiological saline into the experiment. The concentration of 50mg/ml SPF SD rats and randomly divided into smelting workshop of tin smelting dust group, refining workshop tin smelting dust standard quartz dust group and positive control group and saline control group, with only 1ml/ dose by non exposed endotracheal dust method on rats exposed to dust, observation of lung tissue pathological sections of thirtieth days and ninetieth days. And measure the body weight of rats and the whole lung wet weight, lung coefficient calculation, analysis of differences in lung coefficient between groups using SPSS16.0 statistical software.
Results: (1) the general situation and the incidence of pneumoconiosis: tin smelting workshop a total of 385 smelting workers, including 354 males and 31 females, aged 19-56; the total length of service in 0.17-38.00 years, the average total length of 16.51 years; the dust exposed 0.17-36.00 years, the average exposure time of 15.62 years.385 tin smelting in 9 cases of pneumoconiosis patients were male, the detection rate was 2.34%, the patients diagnosed with pneumoconiosis disease at the age of 34~55 (39 + 5.1) years of age, exposure time 9-18 (15.6 + 3.1) years.
(2) the cumulative incidence of patient age: the age of dust exposed workers in tin smelter workers is 9-18 Years, the incidence rate increases with the increase of dust exposure age, and the incidence of dust exposure increases rapidly in 13-18 years.
(3) the cumulative pneumoconiosis and dust exposed correlation analysis: prevalence of tin smelting production workers pneumoconiosis prevalence in the dust exposed 9-23 years, showed a highly positive correlation [correlation coefficient between the exposure time and the cumulative incidence of pneumoconiosis (R) =0.933, P0.05], the regression equation was y=O.003x-0.012.
(4) the content of productive dust and free silica in tin smelting workshop: the dust in the refining workshop is 53.19% and the dust in the refining workshop is 44.25%. After screening, the percentage of dust particles 5 mu m in two workshops is above 90%.
(5) the rat lung coefficient: thirtieth days after exposure to dust, smelting workshop dust group and the differences between the negative control group and positive control group were statistically significant (P0.05), the difference between refining workshop dust group and the negative control group was statistically significant (P0.05), while there was no significant difference between the positive control group (P0.05); the ninetieth day, there was no significant difference between the smelting workshop dust group and negative control group (P0.05), and the difference was statistically significant between the positive control group (P0.05), refining workshop dust group and the negative control group and positive control group differences were statistically significant (P0.05).
(6) the pathological observation of lung tissue: the naked eye, 30 days, two refined group lung tissue was light red, the surface scattered in needle size centered around the dark black, gray white spots, refining group scattered in the center for the surrounding gray black, white spots, irregular shape; 90 days. The lung tissue of rats with refined group showed gray real shape, surface scattered grayish white spots, texture and tough, refining part of rat lung tissue surface grayish black real shape, there are still gray spots.
Under the microscope, the two groups were scattered in the dust particles and dust deposition foci located in the bronchioles, terminal bronchioles, alveolar ducts around dust foci could be seen in the macrophages, fibroblasts, neutrophils and lymphocytes, were inflammation, ninetieth days, smelting dust - visible group inflammatory granuloma formation.
Conclusion: (1) there is a close relationship between the duration of dust exposure and the cumulative incidence of pneumoconiosis in tin smelters. Under the existing working conditions of the factory, if we want to control the prevalence of pneumoconiosis at about 1%, the workers' duration of dust exposure is no more than 7 years.
(2) tin smelting smelting workshop and refining workshop production of dust caused by dyeing changes and ninetieth days of lung tissue showed inflammation of thirtieth animal dust, dust and dust granules in foci within a small amount of dust focal macrophage, lymphocyte proliferation, smelting workshop dust dust visible inflammatory granuloma, pneumoconiosis the early lesion formation, but due to the shorter observation time, still need to observe the longer time or do further research.

【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R135.2

【参考文献】