职业性三氯乙烯药疹样皮炎患者血清肝功能生化指标的动态观察

目的]观察职业性三氯乙烯药疹样皮炎(TCEMD)患者肝功能损害指标的动态变化,为临床诊断及治疗提供依据.方法]检测33例职业性三氯乙烯药疹样皮炎患者人院时和治疗1、2、4、6、8周和出院时的血清肝功能生化指标,包括ALT、AST、GGT、TBil、DBil、IBil和GGT,将检测结果与接触时间和皮炎类型前后对比分析.结果]患者入院时血清肝功能生化指标最高,ALT、AST、GGT、Tbil、Dbil、Ibil和GGT中位数分别达632、332、104.4、51.6、34.5、238μmol/L,肝损伤最严重,经过积极的治疗和护理,各指标逐步下降,2～4周明显改善,但仍维持较高水平；6～8周大致正常,出院时除个别ALT稍高外其它肝功能指标全部降到正常水平.患者人院时各肝功能指标与人院后1、2、4、6、8周和出院时比较,差异有极显著性(P＜0.01).结论]动态观察职业性三氯乙烯药疹样皮炎患者肝功能指标能直观了解疾病发生、发展及转归过程,为进行相应的临床处置提供重要的依据.

Dynamic viewing on serum biochemical index of liver function of patients with trichloroethylene induced medicamentosa-like dermatitis

Objective To observe the dynamic changes of hver biochemical indexs of occupational trichloreth- ylene induced medicamentosa-like dermatitis （TCEMD） patients, and provide basis for clinical diagnosis and treatment. Methods 33 occupational TCEMD patients＇ serum liver biochemical indexs were collected when hospitalized and 1, 2, 4, 6, 8 weeks after treatment respectively, including ALT, AST, GGT, TBil, DBil, IBil and IBil, and their differences were analyzed combining with the contact time and dermatitis types. Results All of the liver function indicators were the highest and the liver was damaged most seriously when patients hospitalized, the medians ofALT, AST, GGT, Tbil, Dbil, Ibil and GGT were 632,332, 104.4, 51.6, 34.5 and 238 μ mol/L respectively, while they all reduced after active treatment and nursing. In 2 - 4 weeks they improved obviously, but still maintained at a high level. All indexs restored to approximately normal levels after 6 ~ 8 weeks. All indicators when hospitalized were higher than those at 1,2, 4, 6, 8 weeks after admission and discharged time, the difference was statistically significant （P 〈 0.01）. Conclusion The dynamic observation on TCEMD patients＇ serum liver biochemical indexs could help intuitively understanding the disease＇ s occurrence, development and transfer process, it could provide an important basis for appropriate clinical management.