三氯乙烯药疹样皮炎患者肝纤维化指标的动态观察

Dynamic study of liver fibrosis in dermatitis medicamentosa-like of trichloroethylene patients

目的分析三氯乙烯药疹样皮炎患者肝功能损害及肝纤维化的动态指标,为临床治疗和预后提供依据。方法选择19名三氯乙烯药疹样皮炎患者,测定初期、急性期和恢复期血清白蛋白(ALB)、直接胆红素(DBIL)、丙氨酸氨基转移酶(ALT)和天门冬氨酸转氨酶(AST)等肝功能指标和肝纤维化四项即透明质酸酶(HA)、III型前胶原(PCIII)、IV型胶原(IV-C)和层粘连蛋白(LN)水平,并分析其变化情况。结果 DBIL、ALT、AST水平逐渐降低,三期差异明显(均P<0.01)。而ALB水平逐渐升高,且初期和急性期比恢复期显著降低(均P<0.01)。HA、PCIII和IV-C水平逐渐降低,HA水平三期差异明显(P<0.01),而PCIII水平初期和急性期均比恢复期明显升高(P<0.01)。结论三氯乙烯药疹样皮炎患者肝脏损害严重,有纤维化的趋势,但多预后良好。

[ Objective ] To provide the evidence for treatment and judgment of prognosis of dermatitis medicamen- rosa-like of trichloro-ethylene patients by studying the changes of liver damage and liver fibrosis in those patients. [ Methods ] The liver function index were determined such as ALB, DBIL, ALT, AST and liver fibrosis index HA, PCIII, IV-C and LN in initial stage, acute phase and convalescence with 19 dermatitis medicamentosa-like of trichloroethylene patients. [ Results ] Compared ~,ith the initial stage, acute phase and convalescence, the levels of DBIL, ALT, AST declined gradually, which were significantly difference among the three phages （P 〈0.01）, but ALB level gradually rose, that the levels in the initial stage and acute phase were decreased obviously than that in the convalescence （P 〈0.01）. In addition, the levels of HA, PCIII and IV-C declined gradually, which the HA level was significant difference among the three phages （P 〈0.01）, but PCIII level obviously rose in the initial stage and acute phase than that in the convalescence （P 〈0.01）. [ Conclusion] Liver damage in dermatitis medicamentosa-like of trichloroethylene patients was serious, and the trend of liver fibrosis was obvious, but the judgment of prognosis was well by proper treatment.