A new health problem due to trichloroethylene - pneumatosis cystoides intestinalis

1.在新泻县进行因素对照研究，调查三氯乙烯(TPI)的使用与胃肠道、皮肤和关节症状发生的关系。接触组女性以腹胀、充气、腹痛、便秘腹泻、大便起泡、血便为特征的特殊症候群较多见；硬皮病样症状以四肢、面部、躯干皮肤硬化、指部皮肤增厚收紧(坐骨神经损伤)为主，男女接触组指部雷诺现象发生率较高。在长野县也进行了一项类似的调查，在那里，三次接触的工人被发现有腹胀和腹痛的剂量依赖性抱怨。对长野县迄今收集的19例经皮冠状动脉介入治疗病例的检查发现：1)3例患者(共7例)在同一工厂工作，2)大多数患者是工作条件恶劣的小型工厂的工人，3)经皮冠状动脉介入患者经常同时接触高浓度的TRI和甲醇。最后一项发现表明，联合暴露于三碘甲烷和甲醇可能在原发PCI.3的发展中起作用。连续3个月，每天给大鼠灌胃三碘甲烷和甲醇，或单独或联合灌胃。尽管在实验期间进行了两次腹部钡灌肠检查，但尸检的组织学检查显示，TRI联合甲醇治疗的大鼠在结肠内出现了粘膜下和/或浆膜下水肿。这种在对照组大鼠中完全不存在的变化是否与冠状动脉介入治疗的发生有关，仍有待研究。

1. A factor-control study was conducted in Niigata Prefecture to survey the relationship between the use of trichloroethylene(TPI)and the occurrence of gastrointestinal, cutaneous and articular manifestations. The particular symptom complex suggesting PCI, which is characterized by abdominal fullness, flatus, abdominal pain, constipation and diarrhea, and foamy, bloody stool appeared more frequently in the exposed females.As to scleroderma-like symptoms, a symptom complex consisting of skin-sclerosis of extremities, face and trunk, thickening and tightening of the skin of fingers(scierodactily), Raynaud's phenomenon of fingers was observed more frequently in the exposed workers of both sexes. A similar survey was also conducted in Nagano prefecture, where abdominal fullness and abdominal pain were found to be dose-dependently complained of in TRI-exposed workers.2. Scrutiny of 19 PCI cases thus far collected by us in Nagano Prefecture revealed that 1)three aroups of patients(7 in total)were working in the same factories, 2)most of the PCI patients were workers in small-scale factories having poor working conditions, and 3)PCI patients were often simultaneously exposed to TRI and methanol at high concentrations. The last finding suggests that co-exposure to TRI and methanol may play a role in the development of primary PCI.3. TRI and methanol were given orally to rats daily for 3 months either singly or in combination. Although abdominal barium enema examination performed twice during the experiment revealed no abnormality, histological examination at autopsy revealed that rats treated with TRI in combination with methanol had submucosal and/or subserosal edemas in the colon. It remains to be studied whether this change, which was completely absent in the control group rats, is etiologically related to the development of PCI.