三氯乙烯药疹样皮炎肝损害的临床观察  

A clinical observation on hepatic dysfunction in epispasis-like dermatitis patients due to trichloroethylene

作　　者：刘惠芳[1] 梁伟辉[1] 陈慈珊[1] 孔凌珍[1] 夏丽华[1] 

机构地区：[1]广东省职业病防治院,广东广州510300

出　　处：《中国工业医学杂志》2004年第6期342-344,共3页Chinese Journal of Industrial Medicine

基　　金：广东省重点科技攻关项目 (编号 :962 2 0 56- 0 5)

摘　　要：目的　了解三氯乙烯药疹样皮炎患者的肝损害情况及规律。方法　对我院的三氯乙烯药疹样皮炎患者 5 5例 (临床分型为 :剥脱性皮炎 2 9例 ,多形红斑 2 2例 ,重症多形红斑 3例 ,大疱性表皮坏死松解症 1例 )的肝损害临床表现及肝功能 (ALT、AST、GGT、TBA、T BIL等 )和病毒性肝炎标志物 (抗 HAV、抗 HCV、HbsAg、HbsAb、HbeAg、HbeAb和HBcAb)的检查进行分析。结果　 5 5例患者有肝损害 5 3例 ,占 96 4%。B型超声波检查提示肝、脾肿大 2 3例 ,占 41 8%。病毒性肝炎标志物检查 4例HbsAg阳性 ,余者均为阴性。在治疗过程中随着激素的使用 ,皮疹逐渐消退肝功能也明显好转 ,一般一周后好转 ,平均 40～ 49d痊愈。结论　三氯乙烯药疹样皮炎的肝损害出现率高 ,且较严重 ;肝功能损害随着皮疹消退而较快恢复 ,一般预后较好 ,但也是造成这类患者死亡的重要原因之一。Objective To i nvestigate the ma nifestations and rules of hepatic dysfuc ntion of epispasislike dermatitis patie n ts due to trichloroethylene exposure. Meth od The clinical manifestations,hep atic f unction(ALT,AST,GGT,TBA and TBIL)and bi omarkers of hepatitis A,B,and C viruses( antiHAV,antiHCV,HbsAg,HbsAb,HbeAg,HbeA b and HbcAb)of 55 hospitalized cases(29 exfoli ative dermatitis,22 erythema multiforme, 3 StevensJohnson syndrome,and 1 toxic e pidermal necrolysis)were analyzed. Result 53 cases(96.4%)showed hepa t ic dysfuncti on,23 cases(41.8%)showed hepatomegaly a nd/or splenomegaly,and HbsAg was positiv e in 4 cases.Along with glucocorticoid t reatment,usually one week later,the tetter was beginning to subside and the hepatic function,to improve. The tetter and hepatic function recovere d for approximately 40-49 days.Con cl usion In the epispasislike dermat itis patients due to trichloroethylene ,the hepatic dysfunction was occurre d in high percentage and severity.After treatment,along with the subsidence of t etter,usually the hepatic dysfun ction was beginning to recover quickly,b ut it also may be the main cause of de ath.

关 键 词：三氯乙烯 药疹样皮炎 肝功能 

分 类 号：R595[医药卫生—内科学] O623.221[医药卫生—临床医学]