三氯乙烯药疹样皮炎个体易感性指标的研究

Study on the index for individual susceptibility of dermatitis medicamentosa-like of trichloroethylene

目的探索磺胺二甲嘧啶检测N-乙酰基转移酶2（NAT2）代谢分型作为三氯乙烯（TCE）药疹样皮炎的个体易感性指标，用于TCE接触劳动者上岗前职业健康检查禁忌证的筛选，减少TCE药疹样皮炎的发生概率。方法比较17例患者和52例健康TCE接触工人N-乙NAT2代谢型分布，并计算相对危险度；对NAT2慢代谢型劳动者进行行政干预，了解干预效果。结果NAT2代谢型在2组间的分布差异有统计学意义（P〈0．01），且NAT2慢代谢型出现三氯乙烯药疹样皮炎的危险性比快代谢型高（OR=10．50；95％CI=2．644～41．695）。干预前后发病率差异有统计学意义（P〈0．05）。结论NAT2代谢分型可能是影响三氯乙烯药疹样皮炎个体易感性的重要原因，利用磺胺二甲嘧啶检测NAT2代谢分型可能可以用于三氯乙烯接触职业禁忌的筛查。

[Objective] To detect N-acetyltransferase 2 （NAT2） metabolic typing by sulfadimidine as the individual susceptibility index of dermatitis medicamentosa-like of trichloroethylene, which was used to screen contraindications among TCE exposure workers in pre-service occupational health examinations, so as to reduce the probability of dermatitis medicamentosa-like of trichloroethylene. [Methods] Comparison of NA T2 metabolic type distribution between 17 patients and 52 healthy workers exposed to TCE was performed, and the relative risk was calculated. Administrative intervention was carried out on NAT2 workers with slow metabolic pattern. The results were observed. [Results] NAT2 metabolic type distribution difference between the 2 groups was significant （P 〈 0.01） , and NAT2 slow metabolizers appeared dermatitis medicamentosa-like of trichloroethylene was more dangerous than fast metabolizers （OR = 10. 50; 95% CI = 2. 644- 41. 695 ）. Difference in the incidence before and after intervention was significant （P 〈0. 05）. [Conclusion] NAT2 metabolic typing may be the important reasons for individual susceptibility of dermatitis medicamentosa-like of trichloroethylene. Detecting NAT2 metabolic typing by sulfadimidine may be used for occupational screening of trichlorethylene exposure contraindications ,