职业性铁及其化合物粉尘肺沉着病患者铁代谢指标分析

发布时间：2018-04-14 09:29

本文选题：铁 + 粉尘　；参考：《中国职业医学》2017年05期

【摘要】：目的观察职业性铁及其化合物粉尘肺沉着病患者脱离粉尘接触约10年后铁代谢指标的改变情况。方法以22例于2004—2006年误诊为电焊工尘肺的职业性铁及其化合物粉尘肺沉着病患者为研究对象,在其脱离粉尘接触约10年后,对其进行胸部高千伏X射线摄影和计算机断层扫描,检测血清铁代谢指标、血常规和血生化指标。随机抽取6例患者进行遗传性血色病基因检测。根据肺部是否有小阴影分为观察组(13例)和对照组(9例)。结果 22例患者血清铁蛋白(SF)水平中位数为858.2μg/L,超标率为77.3%(17/22),其中铁过载占40.9%(9/22)。血清总铁结合力(TIBC)超标率为22.7%(5/22);血清铁超标率为4.5%(1/22)。观察组SF水平高于对照组(P0.05)。SF与丙氨酸氨基转移酶(ALT)呈正相关(P0.05),TIBC与前白蛋白呈正相关(P0.05),血清铁分别与ALT、天冬氨酸氨基转移酶呈正相关(P0.05);上述3个铁代谢指标均与血常规指标、血糖、C反应蛋白不相关(P0.05)。6例患者经遗传性血色病基因检测均可排除遗传性血色病。结论职业性铁及其化合物粉尘肺沉着病患者体内存在铁代谢异常,与铁在肺内沉积有关。
[Abstract]:Objective to observe the changes of iron metabolism in patients with occupational iron and dust pneumonosis after dust exposure for about 10 years.Methods 22 patients with occupational iron and their compound dust pneumoconiosis who were misdiagnosed as welder pneumoconiosis from 2004 to 2006 were studied.Chest high kilovolt X-ray and computed tomography were performed to detect the indexes of serum iron metabolism, blood routine and blood biochemistry.Six patients were randomly selected to detect the genes of hereditary hemochromatosis.According to whether there was a small shadow in the lung, the patients were divided into observation group (n = 13) and control group (n = 9).Results the median of serum ferritin levels in 22 patients was 858.2 渭 g / L, and the rate of exceeding the standard was 77.3% 17 / 22, of which 40.9% were iron overload.The total iron binding capacity of serum TIBC was 22. 7 / 22, and the rate of serum iron exceeded was 4. 5 / 22 / 22.The level of SF in the observation group was higher than that in the control group (P 0.05N. SF and alanine aminotransferase alt).Genetic hemochromatosis could be excluded by genetic detection of Glucose-C-reactive protein (G-CRP) in 6 patients with P0.050.The results showed that the gene of hereditary hemochromatosis could be excluded.Conclusion there is abnormal iron metabolism in patients with occupational iron and its compound dust pneumonosis, which is related to iron deposition in the lung.
【作者单位】：青岛市中心医院职业病防治院;山东大学齐鲁医院呼吸内科;青岛市中心医院放射科;青岛市中心医院呼吸内科;
【分类号】：R135.2

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