肝功能指标在早期慢性苯中毒机体损伤中的价值研究

Study on the value of liver function indexes in early chronic benzene poisoning

目的观察慢性苯中毒患者的肝功能指标水平,探讨其早期判断慢性苯中毒肝功能损害的价值,为临床精准监测慢性苯中毒机体损伤的发生及其早期干预提供循证医学证据。方法选取48名职业性慢性苯中毒患者,根据《职业性苯中毒诊断标准(GBZ 68-2013)》分为轻度组、中度组、重度组,50名健康体检人群做为对照组,分析指标包括ALT、AST、ALP、GGT、TBIL、DBIL、IBIL、TP、ALB和GLB等常规肝功能生化指标。结果单因素方差分析显示各组间ALT(P=0.000)、AST(P=0.000)、ALP(P=0.001)、GGT(P=0.000)、TBIL(P=0.008)和ALB(P=0.000)总体差异有统计学意义。组内分析示各组间ALT、AST、ALP、TBIL均有统计学差异,且和中毒程度具有相关性,提示ALT、AST、ALP、TBIL在苯中毒肝功能损伤中具有更高敏感性。结论ALT、AST、ALP和TBIL可成为辅助诊断早期慢性苯中毒机体损伤的实验室指标。

Objective By observing the levels of liver function indexes in patients with chronic benzene poisoning,to investigate their value of early detection of the liver function damage,and provide evidence-based medical evidence for clinical accurate monitoring of the occurrence of the body damage of chronic benzene poisoning and its early intervention.Methods 48 patients with occupational chronic benzene poisoning were grouped as mild degree group,moderate degree group,severe degree group according to the Criteria of Diagnosis of Occupational Benzene Poisoning(GBZ 68-2013),and 50 healthy people of physical check-up as control.The routine liver function indexes including ALT,AST,ALP,GGT,TBIL,DBIL,IBIL,TP,ALB,GLB were analyzed.Results The result of ANOVA showed that the differences of ALT(P=0.000),AST((P=0.000),ALP(P=0.001),GGT((P=0.000),TBIL((P=0.008),and ALB((P=0.000)were statistically significant.Intragroup analysis by LSD method showed that there were statistically significant differences in ALT,AST,ALP,and TBIL among different experimental groups,which were correlated with poisoning degree.Conclusion ALT,AST,ALP,and TBIL can be used as laboratory parameters to detect physical damage of chronic Benzene poisoning at early stage.