三氯乙烯药疹样皮炎患者细胞因子水平与肝功能损害相关性  

Correlation between cytokine levels and liver function damage in patients with occupational medicamentosa-like dermatitis due to trichloroethylene

作　　者：朱春迎 赵娜[2] 李宏玲[2] 邱新香[2] 吴奇峰[2] 夏丽华[2] 赵新华 王海兰[2] ZHU Chunying;ZHAO Na;LI Hongling;QIU Xinxiang;WU Qifeng;XIA Lihua;ZHAO Xinhua;WANG Hailan(School of Public Health,Guangdong Pharmaceutical University,Guangzhou,Guangdong 510310,China;不详)

机构地区：[1]广东药科大学公共卫生学院,广东广州510310 [2]广东省职业病防治院,广东省职业病防治重点实验室,广东广州510300

出　　处：《中国职业医学》2020年第2期162-167,共6页China Occupational Medicine

基　　金：国家“十二五”科技支撑计划(2014BAI12B01);广东省职业病防治重点实验室(2017B030314152);国家临床重点专科建设项目(2011-09);广东省科技计划项目(2017A020224029)。

摘　　要：目的研究职业性三氯乙烯药疹样皮炎(OMDT)患者血浆细胞因子水平与血清肝功能损害的关系。方法采用判断抽样方法,以22例OMDT患者为研究对象,在入院第1、2、3、4、5周和出院时(恢复期)采集血样,采用自动生化仪检测血清肝功能指标,并采用酶联免疫吸附试验测定血浆中细胞因子肿瘤坏死因子(TNF)-α、干扰素(IFN)-γ、白介素(IL)-5、IL-6和IL-10的水平。对其中15例剥脱性皮炎患者的肝功能和细胞因子水平进行Spearman相关分析。结果与出院时(恢复期)比较,OMDT患者入院第1周(急性期)丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、总胆红素(TBIL)、直接胆红素(DBIL)、谷氨酰转肽酶(GGT)、总胆汁酸(TBA)的水平均升高(P<0.05),总蛋白和白蛋白水平均下降(P<0.05)。对剥脱性皮炎患者相关分析结果显示,在患者入院的第1周,TNF-α、IFN-γ、IL-6水平分别与总蛋白、白蛋白水平存在负相关(P<0.05),IL-5与TBIL水平存在负相关(P<0.05),IL-10与白蛋白水平存在负相关(P<0.05);第2周,IL-6水平与ALT水平均存在正相关(P<0.05);第3周,TNF-α与TBIL水平存在正相关(P<0.05),IL-10与AST水平存在正相关(P<0.05);第4周,TNF-α、IL-10均与ALT、AST水平存在正相关(P<0.05),IFN-γ与AST水平存在正相关(P<0.05);第5周,IL-6、IL-10水平分别与ALT、GGT水平均存在正相关(P<0.05),TNF-α、IFN-γ均与AST水平存在正相关(P<0.05);出院时,TNF-α与DBIL水平存在负相关(P<0.05),与TBA存在正相关(P<0.05)。结论OMDT患者早期伴有较严重的肝功能损害;患者血浆细胞因子TNF-α、IFN-γ、IL-6、IL-10与肝功能损害严重程度存在相关性。Objective To investigate the correlation between plasma cytokine levels and liver functions in patients with occupational medicamentosa-like dermatitis due to trichloroethylene(OMDT).Methods A total of 22 OMDT patients were selected as research subjects using judgment sampling method.Blood samples were collected from patients on the 1st,2nd,3rd,4th,and 5th week of admission and the day of hospital discharge.The automatic biochemical instrument was used for detecting the index of serum liver function.The levels of cytokines including tumor necrosis factor-α(TNF-α),interferon-γ(IFN-γ),interleukin(IL)-5,IL-6,and IL-10 in plasma were measured by enzyme-linked immunosorbent assay.The Spearman correlation analysis was performed to analyze the correlation between cytokines and liver function in 15 patients with exfoliative dermatitis.Results The levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL),direct bilirubin(DBIL),glutamyl transpeptidase(GGT),and total bile acid(TBA)of OMDT patients on the 1st week of admission increased(P<0.05),while total protein(TP)and albumin(ALB)decreased(P<0.05)compared with the results at discharge(a stage of recovery).The correlation analysis results of patients with exfoliative dermatitis showed that:the levels of TNF-α,IFN-γand IL-6 were negatively correlated with the levels of TP and ALB respectively(P<0.05),the level of IL-5 was negatively correlated with TBIL(P<0.05),and the level of IL-10 was negatively correlated with ALB(P<0.05)in the 1st week.The level of IL-6 was positively correlated with ALT(P<0.05)in the 2nd week.The level of TNF-αwas positively correlated with TBIL(P<0.05),the level of IL-10 was positively correlated with AST(P<0.05)in the 3rd week.The levels of TNF-αand IL-10 were positively correlated with AST and ALT respectively(P<0.05),the level of IFN-γwas positively correlated with AST(P<0.05)in the 4th week.The levels of IL-6 and IL-10 were positively correlated with ALT and GGT(P<0.05),and the levels of TNF-αand IFN-

关 键 词：三氯乙烯 药疹样皮炎 细胞因子 肝损害 相关分析 

分 类 号：R135.7[医药卫生—劳动卫生]