摘要
本课题临床部分共有12个单位，11个专业，57名科技医务人员参加。研究的指导思想是：在掌握本病病因学、临床特征及转归等较全面的赍料的基础上，来探讨诊断方法，诊断指标与研制诊断标准，使诊断研究和整个病程发展相结合，以得出合乎客观实际情况，且有概括性、整体观的结论。
The main objectives and achievements ofthe clinical division of the cooperative researchgroup were as follows: Ⅰ. The Diagnosis of Occupational AcuteToxic Hepatopathy (OATH). 221 cases of toxichepatopathy caused by 36 different chemicalswere analyzed with respect to: (1) Etiological fectors, in which the co-ncept or significance of hepatotoxin was elu-cidated, and various types of hepatotoxicitywere assessed according to their effects on theorganism as a whole, laying down therebythe foundation for the overall understandingof the clinical features of the disease. (2) Clinical classification. OATH couldbe divided into hepatotoxic type, multiorgandamage type, and occult type. These catego-ries included all the clinical features of thedisease. (3) Diagnostic criteria. A summarizingsurvey showed that ALT was the most sensi-tive laboratory test for the diagnosis of OATH,and AST the next. Other selective laboratoryassays that might increase the proportion ofpositive diagnosis were serum prealbumin,glycocholic acid, adenosine deaminase, et.No definite value was demonstrated in usingthe ALT/AST ratio. The significance of ultra-sonic B-scanning and liver puncture biopsyin the diagnosis of OATH were also discussed. Ⅱ. The Diagnosis of Occupational ChronicToxic Hepatopathy (OCTH). 306 cases arestudied with respect to: (1) Clinical classification. Three majortypes could be distinguished, i.e., stabiletype, chronic persisting type, and hepaticcirrhrosis type. Like in OATH, these typesincluded all the clinical features of the disea-ses. (2) Diagnostic criteria. a. 23 liver function tests were screenedfor diagnostic efficiency. It was found thatindolcyanine retention test, intravenous tryp-tophan tolerance test, serum tranferrine andglycocholic acid determination were the relati-vely sensitive tests to be used clinically. b. Ultrasonic B-scanning of the liver andits significance in diagnosing hepatopathywere studied. c. Hepatobiliary medical nuclide scanningwas also found to be a more sophisticatedmeans as well as a more objective criterion forthe diagnosis of OCTH. (3) A 3-year dynamic study of 1085 cases of hepatotoxin contact workers in 4 fa-ctories was carried out. All the serial exami-nation data were observed and analyzed syste-matically, guided by the more sensitive labo-ratory criteria mentioned above. Definitivediagnoses were made in 1035 cases. Basing onthis extensive investigation, suggestions weremade by the research section on the steps inthe diagnosis of OCTH and the recommendedmode of logical thinking in dealing with thisentity. A 《Guide for the Health Monitoring ofHepatotoxin Workers》 was established, prov-iding a more practical approach in the diagn-osis of OCTH and the preferential criteria tobe used in the future. Ⅲ. A comprehensive and relatively up-to-date working reference for hygiene professio-nal, 《The Diagnstic Criteria and Principles inManagement of Occupational Toxic Hepatiopa-thy》 was compiled. In addition, a study of combined factorsinfluencing the type and extent of liver dam-age and their differential diagnoses was incl-uded as a part of this cooperative research.
出处
《中国工业医学杂志》
CAS
1991年第2期5-7,共3页
Chinese Journal of Industrial Medicine
