Ultrasonic Features of the Hepatobiliary System in Lead Exposure

Karlova O. O.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

An important issue of practical medical activities is early diagnosis of the damages the target organ, due to the wide distribution of heavy metals, including lead, in the workplace, their ability to accumulate in ecosys- tems and cause multifactorial disease. According to the modern literary studies, lead belongs to xenobiotics with polytropic action, with the defeat of the blood, nervous system, kidneys and gastrointestinal tract. The formation of toxic hepatitis is the result of metabolism of lead in the liver. The above forms the basis to the search criteria for early diagnosis of intoxication in the case of the exposure lead, and justifies the appropriateness of further study of the problem, including the features of structural changes of the hepatobiliary system at ultrasound. Objective. To study the characteristics of ultrasonic changes in workers exposed lead. Materials and methods. The object of the study were 203 persons, male, aged 38-47 years. 146 electricians of cable networkswas included to the main group, and 57 engineers and technicians – to the control group. Patients were divided into 3 groups depending on the content of lead in the blood. By the 1st group included individuals with dangerous levels of lead levels – 2,12 ± 0,013 mcmol/l; to the second group includes workers with acceptable levels of lead and pronounced asthenic – vegetative symptoms – 1,92 ± 0,013 mcmol/l; to the 3rd group includes employee with acceptable levels of lead and certain symptoms of asthenic-vegetative syndrome – 1,72 ± 0,028 mcmol/l. For all employees of the studied groups were conducted ultrasound of the abdomen, which was performed by the standard method [4] with an ultrasonic scanner «Aloka-3500” (Japan) using a convex probe of 5 MHz. Results and discussion. The ultrasonic signs of hepatomegaly were identified in 90,9 ± 4,16 % of the first group (46 workers from dangerous levels of lead in the blood) in 69,56 ± 6,78 % of the second group (32 workers with ac- ceptable levels of lead in the blood) and 20,40 ± 5,72 % (10 employees) of the third group (the permissible level of lead in the blood). The diffuse changes in the liver were identified in 35,29 ± 6,69 % (18 employees) of the first group of workers, in of 21,73 ± 6,08 % (10 employees) of the second group and in 4,08 ± 2,82 % (2 employees) of the third group. Conclusions: steatosis and diffuse changes in the liver are the most common disorders in the structure of sono- graphic pathology, the frequency of which increases with the content of lead in the blood. The hepatomegaly and the increasing of the size of the caudate liver’s fate was found in the of workers of the first group.

ultrasound, lead, hepatomegaly

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«Bulletin of problems biology and medicine» Issue 3 part 3 (112), 2014 year, 126-130 pages, index UDK 616. 36+ 616. 361]:615. 916:546. 815