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題名 | Nitrogen Dioxide-induced Chemical Pneumonitis--Two Cases Report and Preliminary Animal Studies=二氧化氮誘發的化學性肺炎 |
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作者 | 王定一; 蘇義仁; 劉紹興; 許耀平; | 書刊名 | 胸腔醫學 |
卷期 | 14:1 1999.03[民88.03] |
頁次 | 頁24-33 |
分類號 | 415.463 |
關鍵詞 | 化學性肺炎; 二氧化氮肺水腫; 粟粒狀斑紋; Chemical pneumonitis; Nitrogen dioxide; Pulmonary edema; Miliary mottling; |
語文 | 英文(English) |
中文摘要 | 化學性肺炎是一種比較不尋常卻又重要的職業性肺病。許多行業的工 人接觸到有毒的煙霧──其中之一就是二氧化氮。由二氧化氮誘發的化學性肺炎 很少在文獻上發表。大多數病因是接觸到工業上的有毒物體或新鮮的糧秣 (Silo-filler's disease)。在兩例二氧化氮中毒報告中,胸部 X 光上,一個病人顯 示肺水腫,另一個病人顯示粟粒狀斑紋。他們都是在清洗水槽時接觸到二氧化氮 的煙霧。鐵板塗漆前先被放進水槽內,用硝酸鈉和磷酸鋅加以處理,這時候產生 有毒氣體。此種工作環境之下發生二氧化氮中毒的例子在文獻上從來沒有發表 過。用36隻小白鼠做動物試驗來評估吸入二氧化氮後組織學上的變化,以及類 固醇在預防由有毒煙霧誘發的急性呼吸窘迫症候群時有爭議性的作用。接受過類 固醇治療的小白鼠在接觸到二氧化氮後12小時及4天時顯示較少的肺部傷害。 從此試驗可發現二氧化氮會引起嚴重的肺部傷害,因此工作環境中預防措施例如 良好的通風設備是非常重要。我們認為類固醇能減少二氧化氮誘發的肺部傷害。 |
英文摘要 | Chemical pneumonitis is a relatively uncommon but significant occupational lung disease. Workers in a variety of occupations are potentially exposed to toxic agents in the form of fumes and vapors. Chemical pneumonitis caused by nitrogen dioxide is rarely reported in the literature. Most cases are the result of industrial exposure or exposure to fresh silage (silo-filler's disease). Two cases of poisoning by nitrogen dioxide are reported. One patient presented with pulmonary edema and the other with miliary mottling. They were both exposed to nitrogen dioxide gas while cleaning a tank with a mixture of sodium nitrate and zinc phosphate. These chemicals were used to treat steel prior to painting. Chemical pneumonitis from this type of occupational setting has never been reported in the literature. Animal study with 36 mice was conducted to elucidate the histologic changes following nitrogen dioxide inhalation and to evaluate the role of corticosteroid in the prevention of ARDS induced by nitrogen dioxide. Mice which received steroid showed less degree of lung damages at 12 hours and 4 days after exposure to nitrogen dioxide gas. These results indicate that nitrogen dioxide could induce serious lung injury, therefore preventive measures such as good ventilation and recognition of this occupational hazard must be enforced in the workplace. It is found that steroid is of some value in reducing the damage caused by nitrogen dioxide. |
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