甲苯二异氰酸甲酯所致支气管哮喘患者的支气管激发试验及免疫学研究

Bronchial Provocation Test (BPT) and Immunological Investigation of Individuals with Toluene Diisocyanate(TDI) Asthma

对18例临床上诊断为支气管哮喘的TDI作业者进行变应原BPT,并与其它免疫学指标对比观察。发现BPT阳性14例(占77.8％),其中速发反应7例,迟缓反应6例,双相反应1例。BPT阳性者的肺功能指标FVC、FEV_1、MMF、PF、V_(75)、V_(50)、V_(25)等均有明显降低。免疫指标中以IgA、特异性IgE的增高为著,各占7例及9例,并与BPT阳性反应相一致。以上证明了TDI哮喘的变态反应机理,特别是与IgE介导的速发型反应有关。此外,BPT作为一种病因诊断手段,有明显的特异性及实用性。

A specific bronchial provocation test andimmunologic analyse was evaluated in 18 wor-kers, with bronchial asthma after exposureto TDI.A positive BPT was observed in 77.8%of subjects, of them 7 showed immediateresponse and 6 late response while 1 dual re-sponse. The pulmonary function such as FVC,FEV_1, MMF, PF, V_(75), V_(56), V_(2?) reducedmarkedly in individuals with positive BPT. Ahigher levels of lgA, specific IgE to TDI antgienwere detected in 7 and 9 patients respectively,which was consistent with positive BPT. The results of these experiments indicatedthat asthma induced by TDI was allergic me-chanism which was especially related to lgE-mediated mmediate response. As a methedof etiological diagnosis, BPT had obviouslyspecificity and practicality.