二甲基甲酰胺对接触工人肝功能的影响

目的探讨二甲基甲酰胺(DMF)接触浓度、饮酒量及其他因素对DMF接触工人肝功能的影响。方法根据工厂前2年车间空气的监测数据,将DMF分为对照组、低接触组及高接触组。采用问卷调查了解各组研究对象的基本情况及饮酒习惯,采集血样测定肝功能。结果低接触组和高接触组血清丙氨酸转氨酶(ALT)及γ-谷氨酰转肽酶(γ-GT)水平明显高于对照组,高接触组血清天冬氨酸转氨酶(AST)水平高于低接触组;高接触组肝脏指数(Liver index)明显高于对照组和低接触组。多元线性回归分析表明ALT、γ-GT、肝脏指数与接触DMF及体重指数(BMI)相关,ALT还与甘油三酯(TRIG)相关,AST只与工人的饮酒量相关。在肝功能异常者中,有86.7%的AST/ALT比值<1。结论DMF能影响接触工人肝功能,肥胖及饮酒量有一定的协同作用。肝脏指数和AST/ALT比值可作为肝损伤评价和筛选指标。

Abnormal liver function associated with occupational exposure to N, N-dimethylformamide insynthetic leathers works

OBJECTIVE: To investigate the hepatotoxic effects of N, N-dimethylformamide (DMF) in the workers of a synthetic leathers factory, and the effects on liver function of covariates such as alcohol consumption and other factors. METHODS: The workers were classified into three groups (low, high and the control) by the concentration of DMF in workplace which was determined in the past two years. A questionnaire was drawn up for relevant demographic characteristics and other factors influencing liver function. The bloods were collected for laboratory test which included parameters especially relevant to the liver (ALT AST and gamma GT). RESULTS: Low and high-exposure groups were significantly associated with elevated ALT and gamma GT, and high-exposure group was significantly associated with elevated Liver index. Modeling by stepwise regression analysis demonstrated that high concentration of DMF and BMI were associated with and elevated ALT, gamma GT and Liver index, besides DMF and BMI, the elevation of ALT was also associated with high TRIG. AST was only associated with alcohol consumption. The AST/ALT ration < 1 was present in 86.7% of the exposure workers of liver function abnormal. CONCLUSION: DMF can cause liver function alternations even if air concentration of DMF was below PC-TWA. Besides the levels of DMF exposure, obesity (BMI) and alcohol consumption are covariates alternating liver function. Liver index can be a parameter for assessment liver function, and the AST/ALT ration < 1 may serve as markers of risk in health screening programs.