A new health problem due to trichloroethylene - pneumatosis cystoides intestinalis

1. 在新泻县进行了一项因素对照研究，以调查三氯乙烯（TPI）的使用与胃肠道、皮肤和关节表现的关系。暴露的女性更多出现以腹胀、胀气、腹痛、便秘、腹泻、便沫、血为特征的PCI特殊症状群。硬皮病样症状是一种复杂的症状，包括四肢、面部和躯干的皮肤硬化，手指皮肤增厚和收紧（硬皮病性），在接触的男女工人中更常观察到手指雷诺现象。在长野县也进行了类似的调查，发现在接触三氟的工人中，腹胀和腹痛是剂量依赖性的。我们对长野县迄今收集的19例PCI病例进行了审查，发现1)三组患者（共7例）在同一工厂工作，2)大多数PCI患者是工作条件较差的小型工厂的工人，3)PCI患者经常同时暴露于高浓度的TRI和甲醇。最后一项发现表明，TRI和甲醇的共同暴露可能在原发性pci的发展中起作用。TRI和甲醇分别单独或联合给予大鼠每日口服，连续3个月。虽然实验期间进行了两次腹部钡灌肠检查，未发现异常，但尸检时的组织学检查显示，TRI联合甲醇治疗的大鼠结肠粘膜下和/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PCI的发展有病因学上的关系还有待研究。

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.