某焦化厂职业接触多环芳烃焦炉工肝脏某些酶活性的变化

目的探讨多环芳烃(PAHs)对炼焦作业工人某些肝血清酶活性改变的可能影响。方法对乙肝表面抗原(HBsAg)阴性的炼焦作业工人和非PAHs职业接触工人进行总PAHs累积接触指数(CEL-PAHs)评估,尿中1-羟基芘(1-OHP)浓度等级划分,和血清中丙氨酸转移酶(ALT)、天门冬氨酸转移酶(AST)、γ-谷氨酰转移梅(GGT)、碱性磷酸酶(ALP)的检测。结果焦炉工职业性PAHs暴露水平明显高于对照组(P<0·05)。与对照组相比,血清ALT的明显升高可见于CEL-PAHs<50μg/(m3·a)组和尿中1-OHP浓度<2·3μmol/mol肌酐CEL-PAHs≥200μg/m3组,血清AST的明显升高可见于CEL-PAHs<50μg/(m3·a)组;当CEL-PAHs(200μg/(m3·a)或尿中1-OHP浓度≥10·0μmol/mol肌酐时,可发现四种肝生化指标实测值的明显升高(P<0·05),以及ALT、AST和GGT异常率的明显升高(P<0·05),以血清GGT水平的升高(10倍CEL-PAHs的上升导致1·24倍血清GGT水平的升高,10倍尿中1-OHP浓度的上升导致1·19倍的升高)和异常率的上升(logistic回归,调整OR值为6·2~7·2,P<0·05)最为明显。结论PAHs职业暴露可导致炼焦作业工人肝脏某些血清酶活性的升高。

Elevation of some serum liver enzymes in coke oven workers and the possible relationship with exposure to polycyclic aromatic hydrocarbons

OBJECTIVE: To explore the dose-response relationship between exposure to polycyclic aromatic hydrocarbons (PAHs) and the elevation of some serum liver enzymes in coke oven workers. METHODS: Cumulative exposure level of total 16 PAHs (CEL-PAHs) and urinary 1-hydroxypyrene (1-OHP) concentrations were assessed, liver enzymes including alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (GGT) and alkaline phosphatase (ALP) were determined between coke oven workers and non-occupational PAHs exposed workers with negative hepatitis B surface antigens (HBsAg). RESULTS: The exposure levels of PAHs in coke oven workers were significantly higher than in control group (P < 0.05). Compared with referents, significant elevation of serum ALT can be found in the group of CEL-PAHs minor than 50 microg/(m3 x a) or in the group of urinary 1-OHP concentrations minor than 2.3 micromol/mol creatinine, as well as significant elevation of serum AST in the group of CEL-PAHs minor than 50 microg/(m3 x a) (P < 0.05). Compared with control group, the elevation of enzyme level in all four serum liver and the higher prevalence of abnormal serum ALT, AST and GGT level can be found both in the group of CEL-PAHs higher than 200 microg/(m3 x a) and in the group of urinary 1-OHP concentrations higher than 10.0 micromol/mol creatinine (P < 0.05), especially for the elevation of enzyme level in serum GGT (10-fold increase in CEL-PAHs resulted in 1.24-fold increase in serum GGT, as well as 10-fold increase in urinary 1-OHP resulted in 1.19-fold increase) and higher prevalence in serum GGT (logistic analysis: adjusted Odds Ratio: 6.2 - 7.2, P < 0.05). CONCLUSION: The elevation of some liver enzymes in coke oven workers may be related to their high exposure level of PAHs.