Sequential respiratory, psychologic, and immunologic studies in relation to methyl isocyanate exposure over two years with model development.
Sequential respiratory, psychologic, and immunologic studies in relation to methyl isocyanate exposure over two years with model development.
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通过模型开发，对异氰酸甲酯暴露进行了两年的连续呼吸、心理和免疫学研究。
DOI：
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发表时间：
1992
影响因子：
10.4
通讯作者：
M. Naik
中科院分区：
文献类型：
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作者：
S R Kamat;M H Patel;P V Pradhan;S P Taskar;P R Vaidya;V. Kolhatkar;J P Gopalani;J P Chandarana;N. Dalal;M. Naik
在最初在印度博帕尔研究的113名接触甲基异氰酸酯(MIC)的受试者中，79、56、68和87人在3、6、12、18和24个月时进行了临床、肺功能、放射学和免疫学测试。虽然我们的队列包括所有年龄段的受试者，表现出不同的初始疾病严重程度，但女性和年轻受试者较少。起初，所有患者都有眼睛问题，但主要症状是用力呼吸困难、咳嗽、胸痛、痰和肌肉无力。许多人表现出持续的抑郁和焦虑，并伴有人格参数的障碍。早期的X线改变为肺水肿、过度充气、心脏增大、胸膜疤痕和实变。持续的改变是间质沉积。肺功能以限制性改变为主，伴有小气道阻塞，存在氧交换障碍。氧交换在3-6个月时改善，肺活量测定在12个月时改善，但随后下降。与大、中气道功能有关的呼气流速有所改善，但小气道的呼气流速仍然较低。纤维支气管镜检查发现肺泡灌洗液中有肺泡炎改变，其中11例MIC特异性抗体IgM、IgG、IgE阳性。在随访中，只有48%的受试者临床稳定，而50%的受试者表现出波动。32%的受试者有肺功能波动。预测2-4年呼吸困难、用力肺活量、最大呼气流速(0.25-0.75)、最大呼气流速、VO2和抑郁评分的详细顺序行为。临床行为模型除了上述五个参数外，还使用咳嗽、二氧化碳分压和X射线带等因素解释了52.4%的总变异。铁路殖民地组(1640名患者)的行为显示出类似的疾病模式。当这种观察到的变化模式转移到受影响的博帕尔城市部分时(年龄和性别分布均匀)，我们的模型结果再次得到验证。因此，MIC引起的疾病的情况似乎相似，尽管我们的队列和博帕尔市人口的年龄、性别和初始疾病严重程度不同，正如我们的模型预测的那样。ImagesFIGURE 1.图2.
Of 113 methyl isocyanate (MIC)-exposed subjects studied initially at Bhopal, India, 79, 56, 68, and 87 were followed with clinical, lung function, radiographic, and immunologic tests at 3, 6, 12, 18, and 24 months. Though our cohort consisted of subjects at all ages showing a varied severity of initial illness, fewer females and young subjects were seen. Initially all had eye problems, but dominant symptoms were exertional dyspnea, cough, chest pain, sputum, and muscle weakness. A large number showed persistent depression mixed with anxiety, with disturbances of personality parameters. The early radiographic changes were lung edema, overinflation, enlarged heart, pleural scars, and consolidation. The persistent changes seen were interstitial deposits. Lung functions showed mainly restrictive changes with small airway obstruction; there was impairment of oxygen exchange. Oxygen exchange improved at 3-6 months, and spirometry improved at 12 months, only to decline later. The expiratory flow rates pertaining to large and medium airway function improved, but those for small airways remained low. There were changes of alveolitis in bronchoalveolar lavage fluid on fiber optic bronchoscopy, and in 11 cases positive MIC-specific antibodies to IgM, IgG, and IgE were demonstrated. On follow up, only 48% of the subjects were clinically stable, while 50% showed fluctuations. Thirty-two percent of the subjects had lung function fluctuations. Detailed sequential behavior over 2-4 years was predicted for dyspnea, forced vital capacity, maximum expiratory flow rate (0.25-0.75), peak expiratory flow rate, VO2, and depression score. A model for clinical behavior explained a total variance of 52.4% by using the factors of cough, PCO2 and X-ray zones in addition to above five parameters. The behavior of the railway colony group (1640 patients) revealed a similar pattern of illness. When this observed pattern of changes was transferred to the affected Bhopal city sections (with an equitable age-sex distribution), our model results were again validated. Thus the picture of MIC-induced disease seems similar despite the differences for age-sex and initial severity of illness in our cohort and in the population of Bhopal city as predicted by our model. ImagesFIGURE 1.FIGURE 2.
异氰酸甲酯对小鼠的感觉和肺部刺激，以及异氰酸甲酯对豚鼠的肺部刺激和可能的氰化物样作用。
影响因子：
10.4
作者：
Alarie,Y;Ferguson,JS;Stock,MF;Weyel,DA;Schaper,M
通讯作者：
Schaper,M
抗体对异氰酸甲酯的反应：实验和临床发现。
DOI：
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发表时间：
1987
期刊：
Bulletin europeen de physiopathologie respiratoire
影响因子：
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作者：
Karol,MH;Kamat,SR
通讯作者：
Kamat,SR
对产业工人甲苯二异氰酸酯抗体的调查。
DOI：
10.1097/00043764-198111000-00007
发表时间：
1981
期刊：
Journal of occupational medicine. : official publication of the Industrial Medical Association
影响因子：
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作者：
Karol,MH
通讯作者：
Karol,MH