中药材工作者肺部螨感染调查和治疗

目的?摇调查中药材工作者肺螨症的患病情况, 观察甲硝唑治疗肺螨症的疗效。 方法 采用询问病史、痰检螨虫、血检嗜酸粒细胞、ELISA检测血中螨抗体水平和X线胸片检查, 以确诊痰螨感染和肺螨症人数。统计不同工种、年龄、工龄及性别的感染和患病率。痰螨感染者用甲硝唑治疗(剂量为0.8 g/d, 2次分服, 共2个疗程,每疗程7 d, 间隔7～10 d)。统计痰螨阴转率和肺螨症治疗有效率。 结果 调查327人, 痰螨阳性121例, 感染率为37.0%。其中肺螨症患者 (即有呼吸道症状, 嗜酸粒细胞增高或抗体阳性, X胸片异常者)共41例, 患病率为12.5%。不同工种人群的痰螨感染率和患病率不同，以中药材中转库人群最高，分别为51.8%和18.6%。其次是中药厂人群，分别为40.7%和15.7%。两组感染率和患病率均明显高于中药材库和中药店人群（P＜0.01）。中年及工龄较长人群患病率较高（P＜0.05）。不同性别间痰螨感染率和患病率差异均无显著性（P＞0.05）。甲硝唑治疗痰螨阴转率为88.4%，治疗肺螨症患者有效率为92.3%。 结论 中药材工作人群是呼吸道螨感染和肺螨症高发人群之一, 应加强防护。甲硝唑是治疗肺螨症的有效药物。

Survey and Treatment of Pulmonary Acariasis among the Workers Involving inTraditional Chinese Medicinal Materials

OBJECTIVE: To investigate the prevalence of pulmonary acariasis among the employees working on traditional Chinese medicinal materials and observe the effect of treatment. METHODS: History inquiry, detection of mites in sputum, blood examination for eosinophils and specific antibodies, x-ray chest film were carried out for 327 workers involving in traditional Chinese medicinal materials. Mites were found in sputum in 121 persons who were then treated with metronidazole, twice a day with a daily dosage of 0.8g for seven days as a course of treatment. Two courses were conducted with an interval of 7-10 day. Prevalence and morbidity in different groups of occupation, age, and sex were analyzed. RESULTS: The overall infection rate of mites in sputum was 37.0% (121/327) with an average morbidity of 12.5% (41/327). Among the four types of worker investigated, the highest infection rate (51.8%), and morbidity (18.6%) were in those working in transfer warehouse; the second highest infection rate (40.7%) and morbidity (15.7%) were in employees in factory of Chinese traditional medicine. Both groups showed a significant difference with others (chi2inf=11.36, P< 0.01; chi2inc=11.36, P<0.01). Higher morbidity was found in the middle-aged ones and those with more years of service. No difference was found between males and females (chi2=0.31, P>0.05). After treatment with metronidazole, 88.4% showed negative in sputum examination for mites and the efficacy of the treatment for pulmonary acariasis was 92.3%. CONCLUSIONS: Employees engaged in traditional Chinese medicinal materials are one of the groups at the highest risk of pulmonary acariasis. Metronidazole is effective in treating the infection.