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首页> 外文期刊>Occupational and environmental medicine >Non-invasive diagnosis of chronic beryllium disease in workers exposed to hazardous dust in Israel.
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Non-invasive diagnosis of chronic beryllium disease in workers exposed to hazardous dust in Israel.

机译：在以色列接触有害粉尘的工人的非侵入式诊断慢性铍病。

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OBJECTIVES: Chronic beryllium disease (CBD) is caused by prolonged occupational exposure to beryllium and is characterised by various clinical presentations, mostly pulmonary. The inflammatory process involves non-caseous granulomas and proliferation of CD4+ cells. CBD is diagnosed by lung biopsy showing tissue granuloma formation, and by the beryllium lymphocyte proliferation test (BeLPT) for past exposure and sensitisation to beryllium. The induced sputum (IS) technique was developed for diagnosing asthma, chronic obstructive pulmonary disease and interstitial lung diseases. A CD4/CD8 ratio >2.5 in T cells from IS is a positive result for granulomatous lung diseases. We previously revealed that dental technicians are exposed to excessive levels of beryllium. The efficacy of IS (CD4/CD8 >2.5) and BeLPT in diagnosing CBD in 17 workplaces where beryllium was present was evaluated. METHODS: All consecutive patients with a clinical suspicion of CBD referred to our institution for diagnosis and management were enrolled. Results of the gold standard lung biopsy with BeLPT were compared to the non-invasive IS+BeLPT. Kappa and McNemar tests evaluated agreement levels. Correlations between demographic and clinical parameters and a confirmed diagnosis of CBD were analysed. RESULTS: The two approaches were compared in 57 of 98 subjects. There was a high level of agreement (kappa 0.920) between IS+BeLPT and biopsy+BeLPT. IS+BeLPT had a specificity of 97.3% and sensitivity of 87.5%. 21 of 87 exposed workers (24%) had CBD, of whom 12 were dental technicians (p=0.044 dental technicians versus all other occupations). CONCLUSIONS: This study demonstrated that the CD4/CD8 ratio in IS together with positiveegative BeLPT findings can be used in diagnosing CBD.
机译：目的：慢性铍病（CBD）是由长期职业接触铍引起的，其特点是各种临床表现，主要是肺部表现。炎症过程涉及非干酪肉芽肿和CD4 +细胞增殖。通过显示组织肉芽肿形成的肺活检，以及过去对铍的接触和对铍的致敏性的铍淋巴细胞增殖试验（BeLPT），可以诊断出CBD。诱导痰（IS）技术被开发用于诊断哮喘，慢性阻塞性肺疾病和间质性肺疾病。 IS的T细胞中CD4 / CD8比> 2.5是肉芽肿性肺疾病的阳性结果。我们之前曾透露，牙科技术人员会接触过量的铍。评估了IS（CD4 / CD8> 2.5）和BeLPT在存在铍的17个工作场所诊断CBD的功效。方法：所有入选临床怀疑为CBD的患者均转诊至我院进行诊断和治疗。将BeLPT的金标准肺活检结果与无创IS + BeLPT进行了比较。 Kappa和McNemar的测试评估了协议级别。分析了人口统计学和临床​​参数与确诊的CBD的相关性。结果：在98名受试者中的57名中比较了这两种方法。 IS + BeLPT与活检+ BeLPT之间达成了很高的协议（kappa 0.920）。 IS + BeLPT的特异性为97.3％，敏感性为87.5％。在87名暴露的工人中，有21名（24％）患有CBD，其中12名是牙科技师（与其他所有职业相比，p = 0.044牙科技师）。结论：这项研究表明IS中的CD4 / CD8比率以及阳性/阴性BeLPT结果可用于诊断CBD。

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