体检肝功能增加血清甘胆酸的检测意义

某厂为保障职工健康 ,参加社会医疗保险 ,分批组织全厂职工在接受医疗检查血清丙胺酸氨基转氨酶 (AL T)、乙型肝炎表面抗原 (HBs Ag)的基础上 ,又增检血清甘胆酸(CG)。并与 AL T、HBs Ag检出率作对比。现将检验结果报告如下。1　调查对象与方法1.1　调查对象受检者共 85 1人 ,男性 5 76人 ,年龄 2 9～ 5 5岁 ;女性 2 75人 ,年龄 2 5～ 5 0岁。清晨空腹抽静脉血 3 ml,分离血清同时检测 AL T、HBs Ag、CG。1.2　试剂与仪器1.2 .1　 AL T基质液 (上海捷门生物技术公司产品 ,批号990 6 0 1) ,BT2 2 4型半自动生化分析仪 (意大利产 )…     

妊娠期血清甘胆酸浓度测定的临床意义

妊娠期血清甘胆酸浓度测定的临床意义上海市虹口区妇幼保健院２０００８２徐爱娜胆汁酸是在肝细胞酶系作用下由胆固醇转化而来，主要为胆酸与鹅脱氧胆酸组成，它们与甘氨酸及牛磺酸结合形成四种相应的结合胆酸。甘胆酸（ＧｌｙｃｏｃｈｏｌｉｃａｃｉｄＶＧａ）是结合胆酸...     

丙烯腈对作业工人血清甘胆酸测定结果的影响

长期用丙烯腈染毒的动物可出现肝脏病理及功能改变,部分急性中毒患者血清SALT可增高,但对作业工人血清甘胆酸的影响未见报道。本文测定了某厂丙烯腈车间作业工人血清甘胆酸,并进行了全面查体,现将测定结果分析报告如下。     

血清甘胆酸在几种实验性肝损害时的变化规律及其诊断价值

病毒性肝炎病人会出现sGCA水平的改变。而对中毒性肝损害时sGCA的变化规律及其诊断价值未见详细报道。本研究以动物模型做了一些实验,现将结果报告如下。材料和方法1.实验动物选用成年SD雄性大鼠和NIH小白鼠,模型毒物为CCI_4、CE和TNT。实验方法见表1。2.测定指标:sGCA,放射免疫分析法;sGPT活力,金氏法;血清总胆固醇含量,邻苯二甲醛直     

血清铁蛋白与甘胆酸测定对四氯化碳致慢性肝损害的检测价值

本文对四氯化碳作业工人125名,并有乙肝病感染者22名,进行血清铁蛋白与甘胆酸的测定及其他肝功能检查.结果表明,长期接触低浓度四氯化碳可致血清铁蛋白明显升高,接触组与对照组有非常显著差异,并超出正常值范围。由于接触者血清铁蛋白和甘胆酸的异常率亦高,建议作为健康监护的指标之一.     

检测血清铁蛋白和甘胆酸对献血者体检普查意义的探讨

为加强输血安全工作 ,提升血源质量 ,防止输血反应疾病的发生 ,在按照国家法规对无偿献血者必检的血液红细胞(RBC)、血红蛋白 (Hb)、血清谷丙转氨酶 (AL T)、乙肝表面抗原 (HBs Ag)、丙肝病毒抗体 (抗 - HCV)、艾滋病病毒抗体(抗 - HIV)、梅毒抗体等多项体检。本文试测血清铁蛋白 (SF)和甘胆酸 (CG) ,旨在进一步提高体检筛选项目的敏感性和特异性。现将结果报告如下。1　材料与方法1.1　对象　无偿献血者 75 8人次。其中男性 5 16人次 ,年龄2 3～ 4 5岁。女性 2 4 2人次 ,年龄 2 0～ 4 2岁。清晨空腹抽静脉血约 5 ml (RBC和 Hb单…     

对苯二甲酸、乙二醇、联苯 联苯醚长期低剂量接触对工人健康的影响

为探索长期低剂量接触对苯二甲酸( TPA) 、乙二醇( EG) 、联苯联苯醚( DOW) 对工人健康的影响,采用职业流行病学的方法,对某化纤公司1230 名TPA、EG、DOW 作业工人和177 名对照工人进行调查。结果表明,接触组血清ALT、GGT、ALP 活性和尿β2MG 含量明显高于对照组(P< 0-05 或P< 0-01) ;接触组尿蛋白红细胞阳性检出率分另为3-25 % 、6-42 % ,与对照组相比有显著差异(P< 0-05 或P< 0-01) 。提示长期接触低浓度TPA、EG、DOW 可引起工人的肝肾功能改变;TPA、EG、DOW 对作业工人的职业损伤存在联合作用的可能。综合效应评价结果表明,该化纤公司职业危害呈逐年上升趋势     

对苯二甲酸,乙二醇,联苯—联苯醚长期低剂量接触对工人健康 …

为探索长期低剂量接触对苯二甲酸（ＴＰＡ）、乙二醇（ＥＧ）、联苯醚（ＤＯＷ）对工人健康的影响，采用职业流行病学的方法，霜化纤公司１２３０名ＴＰＡ、ＥＧ、ＤＯＷ作业工人和１７７名对照工人进行调查，结果表明，接触组血清ＡＬＴ、ＧＧＴ、ＡＬＰ舔生和尿β２－ＭＧ含量明显高于姐；接触组尿蛋白是性检出率分另为３．２５％、６．４２％，与对照组相比有显著差异。提示长期接触低深度ＴＰＡ、ＥＧ、ＤＯＷ可引起工人的肝肾功     

血清甘胆酸、总胆汁酸检测在妊娠期肝内胆汁淤积症中的临床诊断价值

目的 探讨血清甘胆酸(CG)、总胆汁酸(TBA)检测在妊娠期肝内胆汁淤积症(ICP)中的应用及其临床价值.方法 采用分层抽样方法选取2018年2月-2020年4月我院接诊的60例ICP患者和60例行常规孕检的健康孕妇,其中ICP患者设为观察组,健康孕妇设为对照组.采集两组血清,测定血清TBA、CG.比较不同组别、不同病...     

妊娠期肝内胆汁淤积症血清甘胆酸水平与新生儿预后的关系

目的:探讨妊娠期肝内胆汁淤积症(Intrahepatic Cholestasis of Pregnancy,ICP)患者血清甘胆酸水平对新生儿预后的预测价值。方法:以2003年9月12日～2005年4月28日在重庆医科大学附属第一医院收治的妊娠期肝内胆汁淤积症住院分娩的110例患者为ICP组,年龄23～33岁,平均27.4岁,孕龄37～40+3周。以同期无并发症,无皮肤瘙痒,住院待产的正常孕妇100例,年龄22～34岁,平均26.8岁,孕龄37～41+5周为对照组。ICP诊断按曹泽毅主编的《中华妇产科学》中的相关标准〔1〕。在ICP组中按照甘胆酸水平,把明显升高5倍者分为B组,其余的为A组。CG放免试剂盒由中国原子能科学研究院提供,正常值CG≤300μg/L。Trasylol由德国Bayer,EDTANa2由上海化工试剂厂提供。清晨空腹或于剖宫产前取肘静脉血3 ml,3 000 rpm离心10 min,分离血清于-40℃保存。应用放免法测定血清甘胆酸(μg/L)值,记录分娩方式、胎儿窘迫、新生儿出生评分等新生儿预后情况。结果:①血清甘胆酸在ICP组为(1 698.5±948.5)μg/L,明显高于对照组(142.5±80.1)μg/L,有显著性差异(t=-3.63,P<0.01)。②对照组中剖宫产、胎儿窘迫、新生儿窒息例数均明显低于ICP组,两者之间有差异(χ2=60.29,4.38,10.39,P<0.01,P<0.05,P<0.01)。③随着CG值的升高,新生儿窒息发生率和胎儿宫内窘迫率升高,实施剖宫产率也明显增加。B组中剖宫产、胎儿窘迫、新生儿窒息例数均明显高于A组,两者之间统计学有显著性差异(χ2=11.72,13.18,7.84,P<0.01,P<0.01,P<0.05)。结论:血清甘胆酸水平可能是预测ICP孕妇胎儿宫内情况及其预后的一个重要指标,尤其是甘胆酸水平超过正常值5倍时,对胎儿出生后早期康复干预具有量化数据参考价值。     

Urinary hydroxydiphenyl excretion of workers occupationally exposed to a mixture of diphenyl and diphenylether (Dowtherm A)

Summary A study was carried out in a nylon producing plant to determine exposure to Dowtherm A from frequently occurring leaks in the heating system. The daily exposure to both diphenyl and diphenylether of 20 workers was determined over seven consecutive days. Urine samples before and after the daily eight-hour workshift were obtained and analysed spectro-fluorimetrically on hydroxydiphenyl. Urine concentration of creatinin was used as a correction factor for dilution. No correlation was found between the increase of urinary hydroxydiphenyl during the workshift and the eight-hour average exposure to diphenyl for the individual workers. This could be explained by the small variance of the daily exposure of each worker. Averaging, however, for each worker both exposure values and increases of urinary hydroxydiphenyl over 7 d, resulted in an explained variance of 72.5% using regression techniques. No influence of smoking was found.     

Serum bile acid concentrations as a liver function test in workers occupationally exposed to organic solvents

Summary Liver injury has long been associated with occupational exposure to a wide variety of chemicals. The controversial data existing in relation to hepatotoxicity of organic solvents might be explained as a consequence of the different exposures or it may well be that the tests used for evaluating liver function might not be sensitive enough to detect any mild changes at an early stage. To study liver function during exposure to solvent mixtures, we determined serum bile acid (SBA) concentrations as compared with conventional liver function tests in a selected group of workers (n = 30) occupationally exposed to a mixture of organic solvents (mostly toluene, xylene, acetone, n-butylacetate, n-butanol, ethylacetate) and in a reference group (n = 20). The mean levels of liver enzyme activities and bilirubin concentrations in the two groups were similar, whereas mean SBA levels increased in the exposed group (8.0 ± 6.0 mol/l vs 2.8 ± 1.4 mol/l) and the difference as compared with the controls was significant (P < 0.01). In 73% of the exposed workers, SBA levels were higher than 5.6 mol/l (the cut-off value) as compared with 5% of the controls. These results demonstrate the higher sensitivity in detecting liver dysfunction achieved with the SBA test as compared with conventional hepatic function tests. As increased SBA concentrations are considered to reflect an impairment of anion transport across the liver, higher SBA levels in the group of workers exposed to organic solvents might be explained as a slight and early sign of liver dysfunction. Therefore, SBA determination in biological monitoring of workers exposed to potentially hepatotoxic chemicals might be proposed.     

对苯二甲酸和乙二醇及联苯-联苯醚对职业人群肝肾损伤的研究

目的　研究对苯二甲酸 (TPA)、乙二醇 (EG)、联苯 -联苯醚 (DOW )对职业人群肝肾损伤的影响 ,寻找作业工人健康监护的早期指标。方法　采用职业流行病学的方法 ,在对某化纤公司进行劳动卫生学调查的基础上 ,分析TPA、EG、DOW接触工人肝肾功能的变化。结果　TPA +EG +DOW接触组男工的血清γ 谷氨酰转肽酶 (GGT)活力和总胆汁酸 (TBA)的含量分别为 (35 .45±16 .0 9)U/L、(10 .2 9± 6 .76 ) μmol/L ,女工的血清丙氨酸转氨酶 (ALT)活力和TBA含量分别为(30 .6 8± 8.5 8)U/L、(9.5 3± 6 .6 3) μmol/L ,均不同程度地高于对照组、TPA接触组和DOW接触组 ,且差异有显著性 (P <0 .0 5、P <0 .0 1) ;TPA +EG +DOW接触组尿N 乙酰 β D 氨基葡萄糖苷酶 (NAG)活力和 β2 微球蛋白 (β2 MG)含量与对照组、TPA接触组和DOW接触组相比 ,差异有显著性 (P <0 .0 5、P<0 .0 1) ,男工为 (5 .6 8± 4.0 1)U/mmolCr与 (2 3.49± 13.44 )mg/molCr;女工为 (6 .6 8± 4.6 8)U/mmolCr与 (2 2 .80± 13.0 0 )mg/molCr。经多元回归分析 ,控制了性别、吸烟、饮酒等混杂因素 ,接触不同的毒物与作业工人肝肾损伤的关系有显著性 (P <0 .0 0 1)。结论　TPA、EG、DOW对职业人群的肝肾损伤存在联合作用 ,建议血清ALT、GGT、TBA、尿NAG和     

矽尘接触者血脂质过氧化与微量元素铜、锌的相关分析

作者测试了１１６名矽尘接触者和８９名对照者血中脂质过氧化作用指标［丙二醛（ＭＤＡ）、过氧化物歧化酶（ＳＯＤ）、谷胱甘肽过氧化物酶（ＧＳＨ－Ｐｘ）］和血清铜、锌含量。结果显示，ＭＤＡ、ＳＯＤ、ＧＳＨ－Ｐｘ矽尘组分别为（５．５３１±１．８７２）μｍｏｌ／Ｌ、（２３９６±４１３）μｍｏｌ／（ｍｉｎ·ｇ）、（３５．０６±８．９４）μｍｏｌ／（ｍｉｎ·ｇ），均显著高于对照组。血清铜、锌、铜／锌比值矽尘组分别为（２４．８０±６．５６）μｍｏｌ／Ｌ、（１３．１１±４．６６）μｍｏｌ／Ｌ、２．２１±０．８７，血清铜、铜／锌比值明显高于对照组，而血清锌两组无显著差异。各指标间相关分析表明，ＭＤＡ与Ｃｕ、ＭＤＡ与Ｃｕ／Ｚｎ；ＳＯＤ与Ｃｕ、ＳＯＤ与Ｃｕ／Ｚｎ以及Ｃｕ与Ｃｕ／Ｚｎ呈正相关。其他指标之间无相关关系。作者认为生物膜的脂质过氧化和铜代谢在ＳｉＯ２所致的肺纤维化的病理机制中起重要作用，是肺纤维化有意义的指标，对判断肺损伤可能具有一定的价值。     

长期接触低浓度氨工人肝功能的改变

对长期接触低浓度氨工人血氨和血清ALT进行测定,以探讨长期接氨对肝功能的影响。结果表明长期低浓度氨接触可使肝功能出现轻微异常,脱离氨作业环境后,肝功能可逐步恢复正常。     

^13C-美沙西丁呼气试验定量评估非酒精性脂肪肝肝贮备功能

目的探讨^13C-美沙西丁呼气试验定量评估非酒精性脂肪肝肝细胞损害程度的方法及意义。方法雄性Wistar大鼠24只随机分为对照组（普通饮食）和模型组（高脂饮食）,分别于8和12周末对两组大鼠进行^13C-美沙西丁呼气试验检测,观察呼气峰值（DOB）、达峰时间（T）、达峰高度和60min累积呼气量（CUM_60min）各参数的动态变化;处死动物,测门静脉、腹主动脉血中内毒素（ET）水平;取肝标本做HE染色,观察其病理变化。结果8周模型组呼气试验参数与同期对照组比较无统计学意义;12周模型组DOB、CUM_60min和达峰高度与同期对照组比较差异有统计学意义（P〈0．01）,T较对照组前移,但差异无统计学意义（P〉O．05）。呼气试验结果与肝脏HE染色病变一致。8周、12周模型组门静脉ET水平较同期对照组明显上升,差异有统计学意义（P〈0．01）。腹主动脉与相应门静脉ET水平比较差异有统计学意义（P〈0．01）。门静脉ET水平与DOB、呼气试验丰度和CUM_60min呈正相关（P〈0．05）。结论^13C-关沙西丁呼气试验有可能成为一种非酒精性脂肪肝肝细胞功能的无创性评价方法。     

Two-year observation of pulmonary function in workers exposed to low concentrations of toluene diisocyanate

Summary Pulmonary effects were investigated in 106 toluene diisocyanate (TDI)-exposed workers and 39 referents in 1980 and in 64 exposed workers and 21 referents on the 2-year follow-up study in 1982. Means of individual, time-weighted average (TWA) exposure concentrations measured by personal monitors were approximately 0.001 ppm in each year. Short-term exposure at 0.02 ppm or over was observed in 9.3% of the collected samples in 1980 and 1.9% in 1982. Pulmonary function was assessed by measurements of maximum expiratory flow-volume curve and respiratory impedance. No differences were observed in the means of the pulmonary functions and their individual daily changes between the TDI workers and the referents. Significant intra-individual, two-year decreases were observed in some pulmonary function parameters in both groups, but when the effect of aging was adjusted, the decreases disappeared. Prevalences of respiratory symptoms in the TDI workers were not significantly higher than those in the referents, except for irritating complaints of the eyes and throat probably due to peak exposure to TDI and/or co-existing irritants. Eight of the TDI workers had episodes of acute asthmatic reactions shortly after having begun their TDI jobs and most parameters in their maximum expiratory flow were significantly less than the predicted values, though exposure concentrations when the episodes occurred could not be defined. From these results, it was suggested that TDI exposure at the levels of 0.001 ppm may not induce adverse pulmonary effects when the workers are not hypersusceptive to TDI.     

Comparison of neurobehavioral function in workers exposed to a mixture of organic and inorganic lead and in workers exposed to solvents

The neurobehavioral effects of lead (organic and inorganic) and organic solvents were compared in 386 U.S. workers (52 reference, 190 lead, and 144 solvent workers). The association between neurobehavioral test performance and duration of exposure to lead or solvents was also examined and compared. The neurobehavioral test battery consisted of examiner and computer-administered neurobehavioral tests, a test of olfactory function, and questionnaires that assessed neuropsychiatric symptoms. Adjusted mean differences on the neurobehavioral test scores were estimated by comparing the exposed group to the referent group using linear regression and adjusting for premorbid intellectual ability, age, and race. Both lead and solvents were associated with diminished neurobehavioral performance in all neurobehavioral areas tested. Specifically, while lead and solvent exposure had the same magnitude of adverse effects on tests of manual dexterity, lead exposure was associated with greater adverse effects on memory and learning tests but with less adverse effects on executive/motor tests and on a test of olfaction than solvent exposure. An elevated number of neuropsychiatric symptoms was reported by 7% of the referent group, 43% of the lead group, and 15% of the solvent group. For exposure duration of ?10 years, more neurobehavioral decrements were found in the solvent group relative to the lead group. However, for exposure duration of ?18 years, the lead group showed more decrements than the solvent group. Overall, these data suggest differences in neurobehavioral functioning between the lead (organic and inorganic) and solvent exposed workers examined in this study.     

单纯性肥胖儿童血脂、血清铁蛋白与脂肪肝的关系

[目的]探讨3～6岁中重度单纯性肥胖儿童血脂、血清铁蛋白与脂肪肝的关系.[方法]选取大连市托幼园所的在园儿童111例,中重度单纯性肥胖儿童69例,正常对照组42例.两组均进行血脂、血清铁蛋白及肝脏B超检查.[结果]①肥胖组血清总胆固醇、甘油三酯、低密度脂蛋白胆固醇、血清铁蛋白均高于正常对照组（P＜0.01）.②肥胖组血清铁蛋白与甘油三酯具有相关性（r=0.324,P＜0.05）.③B超检查显示肥胖组儿童有13例并发脂肪肝,发病率为18.84%;正常对照组无1例脂肪肝发生（P＜0.01）.④肥胖脂肪肝组血清铁蛋白高于肥胖无脂肪肝组（P＜0.05）.[结论]中重度单纯性肥胖儿童已发生明显的脂代谢紊乱;中重度单纯性肥胖儿童并发脂肪肝较为常见,发病率为18.84%;血清铁蛋白对中重度单纯性肥胖儿童脂肪肝的早期诊断可能具有重要意义.     

Ventilatory function of workers exposed to cobalt and diamond containing dust

Summary The ventilatory function of 48 workers occupied on the average for six years in a plant producing diamond-cobalt circular saws was compared with that of 23 control subjects. The geometric mean airborne cobalt concentrations in the two main work areas amounted to 15.2 and 135.5 g/m³ respectively. The spirometric changes found in the exposed workers were compatible with a moderate restrictive syndrome and were correlated with duration of exposure.