Long-term complications of sulphur mustard poisoning in severely intoxicated Iranian veterans
Long-term complications of sulphur mustard poisoning in severely intoxicated Iranian veterans
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DOI：
10.1111/j.1472-8206.2005.00364.x
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发表时间：
2005-12-01
影响因子：
2.9
通讯作者：
Jaafari, MR
中科院分区：
文献类型：
--
作者：
Balali-Mood, M;Hefazi, M;Jaafari, MR
硫芥（SM）是一种烷基化化学战剂，在第一次世界大战和两伊冲突中被广泛使用。SM在不同器官中的迟发性并发症及其严重程度相关性以前尚未报道。皮肤科，眼科，神经和呼吸系统检查，以及肺功能测定，气体测量，高分辨率计算机断层扫描的胸部，肌电图，神经传导速度，细胞计数，流式细胞仪分析，血清免疫球蛋白和补体因子的测量进行了所有严重SM中毒的退伍军人在呼罗珊省，伊朗。还对由35名健康男性受试者组成的对照组进行了血液学和免疫学研究。皮肤，眼睛和呼吸系统并发症的严重程度分为四个等级，并确定其相互之间的相关性，以及与血液学和免疫学参数，使用斯皮尔曼的等级相关性检验。研究了40名男性患者（年龄43.8 +/- 9.8岁），在暴露后16-20年证实SM中毒。最常见的并发症是肺部（95%）、周围神经（77.5%）、皮肤（75%）和眼睛（65%）。与对照组相比，患者组WBC、RBC、HCT、IgM、C3、单核细胞和CD 3+淋巴细胞百分比显著升高（P < 0.042），CD1.6 + 56阳性细胞百分比显著降低（P = 0.006）。呼吸系统并发症的严重程度与眼部并发症的严重程度（r = 0.322，P = 0.043）、血红蛋白（r = 0.369，P = 0.024）和红细胞压积（r = 0.470，P = 0.003）显著相关。虽然SM中毒的皮肤、眼睛和呼吸系统的晚期并发症主要是由于其直接毒性作用，但神经肌肉、血液学和免疫学并发症可能是全身毒性的结果。
Sulphur Mustard (SM) is an alkylating chemical warfare agent that was widely used during the World War I and in the Iran-Iraq conflict. Delayed complications of SM in different organs and their severity correlations have not previously been reported. Dermatological, ophthalmological, neurological and respiratory examinations, as well as spirometry, gasometry, high resolution Computed tomography scanning of the chest, electromyography, nerve conduction velocity, cell blood counts, flow-cytometric analyses, and measurement of serum immunoglobulins and complement factors were performed on all severely SM poisoned veterans in the province of Khorasan, Iran. Haematological and immunological studies were also performed on a control group consisting of 35 healthy male subjects. The severity of dermal, ocular and respiratory complications were classified into four grades and their correlations with each other as well as with the haematological and immunological parameters were determined, using Spearman's rank correlation test. Forty male patients (aged 43.8 +/- 9.8 years) with confirmed SM poisoning 16-20 years after the exposure were studied. The most common complications were found in the lungs (95%), peripheral nerves (77.5%), skin (75%), and eyes (65%). WBC, RBC, haematocrit (HCT), IgM, C3, and the percentages of monocytes and CD3(+) lymphocytes were significantly (P < 0.042) higher and the percentage of CD1.6 + 56 positive cells was significantly (P = 0.006) lower in the patients than in the control group. The severity of respiratory complications revealed a significant correlation with the severity of ocular complications (r = 0.322, P = 0.043), as well as with the haemoglobin (r = 0.369, P = 0.024) and HCT (r = 0.470, P = 0.003). Although late complications of SM poisoning in the skin, eyes, and respiratory system are mainly due to its direct toxic effects, the neuromuscular, haematological and immunological complications are probably the result of systemic toxicity.