THE PULMONARY SEQUELAE ASSOCIATED WITH ACCIDENTAL INHALATION OF CHLORINE GAS
THE PULMONARY SEQUELAE ASSOCIATED WITH ACCIDENTAL INHALATION OF CHLORINE GAS
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DOI：
10.1378/chest.97.4.820
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发表时间：
1990-04-01
期刊：
影响因子：
9.6
通讯作者：
LAKSHMINARAYAN, S
中科院分区：
文献类型：
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作者：
SCHWARTZ, DA;SMITH, DD;LAKSHMINARAYAN, S
1975 年，20 名原本健康的人意外接触了高浓度的氯气。在接下来的 12 年里，我们多次对这些人进行了肺功能测试。平均而言，每位受试者都接受了 8.5 年的随访，20 名暴露者中的 13 人在暴露后 12 年后接受了测试。事故发生后一天进行的肺功能测试最显着的是气流阻塞和空气滞留的发生率很高。在接下来的几年里，气流阻塞持续存在；然而，空气滞留的高发生率得到了解决。值得注意的是，低残液量的发生率在随访期间持续增加 (p < 0.001)，在第 12 年，67% 的测试者的残液量低于其预测值的 80%。我们还发现，12 岁时接受测试的 13 名受试者中有 5 名对吸入乙酰甲胆碱的气道反应性有所增加（FEV1 下降 > 15%）。那些具有反应性气道的个体年龄较大（p = 0.004），并且在暴露后立即出现更明显的气流阻塞（p = 0.03）和空气滞留（p = 0.03）。这些数据表明，暴露于高浓度氯气可能会导致长期肺部并发症，其特征是残余量减少。不幸的是，这些数据使我们无法确定氯暴露是否导致气道反应性的发展，或者反应性气道的存在是否导致了暴露于氯气后观察到的空气滞留。
Twenty previously healthy individuals were accidentally exposed to high concentrations of chlorine gas in 1975. Pulmonary function tests were performed on these individuals on several occasions over the next 12 years. On average, each subject was followed up for 8.5 years and 13 of the 20 exposed persons were tested 12 years following the exposure. Pulmonary function tests obtained one day following the accident were most notable for the high prevalence of airflow obstruction and air trapping. Over the ensuing years, the airflow obstruction persisted; however, the high prevalence of air trapping resolved. Of note, the prevalence of a low residual volume consistently increased during the follow-up period (p < 0.001) and at year 12, 67 percent of those tested had residual volumes below 80 percent of their predicted value. We also found that five of 13 subjects tested at year 12 had an increase in airway reactivity (> 15 percent decline in FEV1) to inhaled methacholine. Those individuals with reactive airways were older (p = 0.004) and had more marked airflow obstruction (p = 0.03) and air trapping (p = 0.03) immediately following the exposure. These data suggest that exposure to high concentrations of chlorine gas may result in long-term pulmonary complications that are characterized by a reduced residual volume. Unfortunately, these data preclude us from determining whether the chlorine exposure led to the development of airway reactivity or the presence of reactive airways accounted for the air trapping that was observed following the exposure to chlorine gas.