李培茂, 林大枫, 任晓虎, 刘建军, 孔秋月, 刘慧敏, 张艳芳, 黄先青. 三氯乙烯药疹样皮炎肝脏自身免疫性指标分析[J]. 职业卫生与应急救援, 2019, 37(1): 15-18. DOI: 10.16369/j.oher.issn.1007-1326.2019.01.004
引用本文: 李培茂, 林大枫, 任晓虎, 刘建军, 孔秋月, 刘慧敏, 张艳芳, 黄先青. 三氯乙烯药疹样皮炎肝脏自身免疫性指标分析[J]. 职业卫生与应急救援, 2019, 37(1): 15-18. DOI: 10.16369/j.oher.issn.1007-1326.2019.01.004
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LI Peimao, LIN Dafeng, REN Xiaohu, LIU Jianjun, KONG qiuyue, LIU Huimin, ZHANG Yanfang, HUANG Xianqing. Analysis of liver autoimmune indices in patients with trichloroethylene-induced medicamentosa-like dermatitis[J]. Occupational Health and Emergency Rescue, 2019, 37(1): 15-18. DOI: 10.16369/j.oher.issn.1007-1326.2019.01.004
Citation: LI Peimao, LIN Dafeng, REN Xiaohu, LIU Jianjun, KONG qiuyue, LIU Huimin, ZHANG Yanfang, HUANG Xianqing. Analysis of liver autoimmune indices in patients with trichloroethylene-induced medicamentosa-like dermatitis[J]. Occupational Health and Emergency Rescue, 2019, 37(1): 15-18. DOI: 10.16369/j.oher.issn.1007-1326.2019.01.004
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三氯乙烯药疹样皮炎肝脏自身免疫性指标分析

Analysis of liver autoimmune indices in patients with trichloroethylene-induced medicamentosa-like dermatitis

    摘要
  • 摘要:
    目的 探索三氯乙烯药疹样皮炎（occupational medicamentosa-like dermatitis induced by trichloroethylene，OMDT）引发的肝脏自身免疫情况。
    方法 选取10例OMDT慢性期患者和5名门诊随访的治愈者作为研究对象，检测肝功能指标丙氨酸氨基转移酶（ALT）和自身免疫性肝炎（AIH）相关免疫指标免疫球蛋白（IgG）、抗核抗体（ANA）、抗平滑肌抗体（ASMA）、抗肝肾微粒体抗体（LKM-1）、抗肝溶质抗原1型抗体（LC-1）、抗可溶性肝抗原/肝胰抗原抗体（SLA/LP）、抗线粒体亚型-2抗体（AMA-M2），比较、分析各指标在慢性期患者和治愈者中的水平。
    结果 慢性期患者肝功能指标ALT活性中位数（49.5 U/L）高于临床参考值，但IgG浓度（4.74~11.32 g/L）均在参考值范围内，且自身抗体指标均为阴性。治愈者ALT活性中位数（10.0 U/L）在参考值范围内，但其中1人（20%）IgG浓度高于临床参考值，ANA阳性率为60%，其他自身抗体指标均为阴性。慢性期患者ALT活性中位数高于治愈者，而治愈者ANA阳性率高于慢性期患者，差异均有统计学意义（P < 0.05）。
    结论 OMDT患者在慢性期期间虽然肝功能受损，但可能未发生自身免疫；治愈后肝功能基本恢复，部分自身免疫指标却可能升高。

     

    Abstract:
    Objective This study was to preliminarily analyse manifestation of liver autoimmunity in patients with trichloroethylene-induced medicamentosa-like dermatitis.
    Methods Totally 15 patients, 10 cases in chronic phase and 5 patients in recovery phase, were analyzed in detail. The liver function indices, such as ALT and autoimmune hepatitis-related indices, including immunoglobulin G (IgG), antinuclear antibody (ANA), anti-smooth-muscle antibody (ASMA), anti-liver-kidney-microsomes antibody (LKM-1), anti-liver-cytosol antigen type 1 antibody (LC-1), anti-soluble-liver antigen/liver-pancreas antigen antibody(SLA/LP)and anti-mitochondrial subtype 2 antibody(AMA-M2) were examined and compared between the patients in chronic phase and recovery phase.
    Results The median of ALT activity of patients in the chronic phase was 49.5 U/L, which was higher than the reference value. Their IgG concentrations varied from 4.74-11.32 g/L and were in the scope of reference values, and other autoantibody indices were all negative. The median of ALT activity of patients in recovery phase was 10.0 U/L, but one patient had IgG concentration higher than the reference value and 3 cases had positive ANA, while other cases' autoantibody indices were all negative. The ALT activity of patients in the chronic phase patients was higher than that of patients in recovery phase, while the positive rate of ANA in the patients in recovery phase was higher than that of patients in chronic phase (P < 0.05).
    Conclusion Results indicated that patients in chronic phase had damage of liver function but no occurrence of autoimmunity; the patients in recover phase had normal liver function, but some cases had occurrence of the autoimmune indices.

     

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