职业性三硝基甲苯性白内障的临床研究动态

Clinical study development on occupational cataract induced by trinitrotoluene

本文就职业性TNT白内障的发病机制、临床表现及诊断等进行了综述,以为现行职业性白内障国家诊断标准的修改提供参考。职业性三硝基甲苯(TNT)所致晶状体损害的发生率、发生时间、进展率和进展程度与TNT接触的时间、浓度等密切相关。目前在TNT性白内障形成机制方面尚无肯定的结论。晶状体摄影能客观真实地反映出晶状体混浊的形态、范围、浓密程度,便于混浊范围的测量,有利于确定TNT白内障病变的分期与分级,可为职业性眼病及劳动能力的鉴定提供有力的证据。TNT白内障用药治疗难以取得明显的疗效。加强防护可以预防TNT白内障的发生。

The pathogenesis, main clinical manifestations and diagnosis of occupational TNT cataract were reviewed in this paper. Occupational cataract is a toxic oculopathy, lens opacification is the main manifestation that needs long term exposure to TNT. Its incidence, latency and progress are closely correlated with the term and concentrations of TNT exposure, but the mecha- nism of TNT cataract is still not clear until now. The eye lens photograph could objectively reflect the morphous, scope and density of lens opacification, and measure the area of opacity, which would be helpful to diagnosis and classification of TNT cataract, which also offers a good evidence for the work ability identification of occupational eye disease. The effect of drug treatment for TNT cataract is little, but good individual protection could well prevent the occurance of TNT cataract. The paper suggests that the actual diagnostic criteria of occupational TNT cataract （ GBZ45--2002 ） is not so perfect and needs revision.