中华劳动卫生职业病杂志
中華勞動衛生職業病雜誌
중화노동위생직업병잡지
CHINESE JOURNAL OF INDUSTRIAL HYGIENE AND OCCUPATIONAL DISEASES
2012年
4期
284-288
,共5页
赵娜%王海兰%越飞%曾泽明%李宏玲%黄永顺%陈润涛
趙娜%王海蘭%越飛%曾澤明%李宏玲%黃永順%陳潤濤
조나%왕해란%월비%증택명%리굉령%황영순%진윤도
三氯乙烯%皮炎,职业性%补体
三氯乙烯%皮炎,職業性%補體
삼록을희%피염,직업성%보체
Trichloroethylene%Dermatitis,occupational%Complement
目的 观察三氯乙烯(TCE)接触工人及职业性TCE药疹样皮炎(OMDT)患者体内补体相关免疫指标的变化情况,为其发病机制研究提供线索.方法 收集8例确诊为OMDT患者入院时、入院第1、2、3、4、5周和出院时共7次血液样本,进行肝功能、免疫球蛋白和补体相关指标检测,同时以39名未发病的TCE接触工人为接触组,检测车间空气中TCE浓度以及工人8h TCE时间加权平均浓度；收集工人尿液和血液样本,检测尿液中三氯乙酸(TCA)含量；分析接触工人血液中补体相关免疫指标与病例组的差异.结果 与入院时[C3d-CIC:(92.86±44.80)mg/L,C3:(0.91±0.19)mg/L]相比,OMDT患者出院时C3d-CIC水平[(52.41±17.75)mg/L]降低,C3含量[(1.14±0.22) mgL]升高,差异均有统计学意义(P＜0.05).其中C3含量随着病情好转逐渐上升.4家调查工厂空气中TCE浓度为(351.96±36.72)mg/m3,均超过国家规定的职业接触限值,接触工人8hTCE时间加权平均浓度与尿中TCA含量超过国家规定职业接触限值的人数分别占调查总人数的28.21％和56.41％.与OMDT患者出院时[IgG:(10.03±l.21)mg/L；CIC:(103.50±29.17 )mg/L]相比,TCE接触组IgG[( 17.21±1.85 )mg/L]和CIC[(227.46±111.67) mU/L]含量增高,差异均有统计学意义(P＜0.01).其他指标比较,差异无统计学意义(P＞0.05).结论 OMDT发病机制中可能涉及Ⅱ型和Ⅲ型变态反应,从而引起脏器损伤.
目的 觀察三氯乙烯(TCE)接觸工人及職業性TCE藥疹樣皮炎(OMDT)患者體內補體相關免疫指標的變化情況,為其髮病機製研究提供線索.方法 收集8例確診為OMDT患者入院時、入院第1、2、3、4、5週和齣院時共7次血液樣本,進行肝功能、免疫毬蛋白和補體相關指標檢測,同時以39名未髮病的TCE接觸工人為接觸組,檢測車間空氣中TCE濃度以及工人8h TCE時間加權平均濃度；收集工人尿液和血液樣本,檢測尿液中三氯乙痠(TCA)含量；分析接觸工人血液中補體相關免疫指標與病例組的差異.結果 與入院時[C3d-CIC:(92.86±44.80)mg/L,C3:(0.91±0.19)mg/L]相比,OMDT患者齣院時C3d-CIC水平[(52.41±17.75)mg/L]降低,C3含量[(1.14±0.22) mgL]升高,差異均有統計學意義(P＜0.05).其中C3含量隨著病情好轉逐漸上升.4傢調查工廠空氣中TCE濃度為(351.96±36.72)mg/m3,均超過國傢規定的職業接觸限值,接觸工人8hTCE時間加權平均濃度與尿中TCA含量超過國傢規定職業接觸限值的人數分彆佔調查總人數的28.21％和56.41％.與OMDT患者齣院時[IgG:(10.03±l.21)mg/L；CIC:(103.50±29.17 )mg/L]相比,TCE接觸組IgG[( 17.21±1.85 )mg/L]和CIC[(227.46±111.67) mU/L]含量增高,差異均有統計學意義(P＜0.01).其他指標比較,差異無統計學意義(P＞0.05).結論 OMDT髮病機製中可能涉及Ⅱ型和Ⅲ型變態反應,從而引起髒器損傷.
목적 관찰삼록을희(TCE)접촉공인급직업성TCE약진양피염(OMDT)환자체내보체상관면역지표적변화정황,위기발병궤제연구제공선색.방법 수집8례학진위OMDT환자입원시、입원제1、2、3、4、5주화출원시공7차혈액양본,진행간공능、면역구단백화보체상관지표검측,동시이39명미발병적TCE접촉공인위접촉조,검측차간공기중TCE농도이급공인8h TCE시간가권평균농도；수집공인뇨액화혈액양본,검측뇨액중삼록을산(TCA)함량；분석접촉공인혈액중보체상관면역지표여병례조적차이.결과 여입원시[C3d-CIC:(92.86±44.80)mg/L,C3:(0.91±0.19)mg/L]상비,OMDT환자출원시C3d-CIC수평[(52.41±17.75)mg/L]강저,C3함량[(1.14±0.22) mgL]승고,차이균유통계학의의(P＜0.05).기중C3함량수착병정호전축점상승.4가조사공엄공기중TCE농도위(351.96±36.72)mg/m3,균초과국가규정적직업접촉한치,접촉공인8hTCE시간가권평균농도여뇨중TCA함량초과국가규정직업접촉한치적인수분별점조사총인수적28.21％화56.41％.여OMDT환자출원시[IgG:(10.03±l.21)mg/L；CIC:(103.50±29.17 )mg/L]상비,TCE접촉조IgG[( 17.21±1.85 )mg/L]화CIC[(227.46±111.67) mU/L]함량증고,차이균유통계학의의(P＜0.01).기타지표비교,차이무통계학의의(P＞0.05).결론 OMDT발병궤제중가능섭급Ⅱ형화Ⅲ형변태반응,종이인기장기손상.
Objective To explore the mechanism of occupational medicamentosa-like dermatitis (OMDT) induced by trichloroethylene (TCE) and some immunity indexes in workers occupationally exposed to TCE.Methods The blood samples from 8 cases with medicamentosa-like dermatitis in 1st,2nd,3rd,4th and 5th weeks after admitting to hospital were examined for liver function,immunoglobulin and some complement indexes.Thirty nine workers occupationally exposed to TCE were investigated for urinary TCE and some immuno-complement indexes.The TCE concentrations of air in workplaces were monitored.Results C3d-CIC and C3 of patients before admission were (92.86±44.80) mg/L and 0.91±0.19 mg/L,respectively.C3d-CIC and C3 of patients before discharge were (52.41±17.75) mg/L and (1.14±0.22) mg/L,respectively.There were significant differences between admission and discharge (P＜0.05).The average TCE concentration in 4 workplaces was (351.96±36.72) mg/m3,which was higher than the occupational exposure limits (OELs).The number of workers exposed to the TCE concentration-time weighted and TCA in urine over OELs were 28.21％ and 56.41％ of total subjects,respectively.The serum IgG and CIC levels of patients before discharge were ( 10.03±1.21) mg/L and 103.50±29.17 mU/L,which were significantly lower than those (17.21±1.85) mg/L and (227.46±111.67) mU/L of patients before admission (P＜0.01).Conclusion The type Ⅱ and Ⅲ hypersensitivity may be associated with OMDT and the organ injure induced by TCE.
