Yao Hongwei, Wang Xinru, Wang Dingxian, Shi Aimin, Xu Xikun, Yang Zhengnan, Li Zelin
Third Affiliated Hospital of Nanjing Medical University, Nanjing 211900, China.
Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2002 Feb;20(1):5-9.
To study injury of liver and kidney among the workers exposed to terephthalic acid(TPA), ethylene glycol(EG) and(or) dowtherm A(DOW), and research for early biological monitoring indexes.
By using the method of occupational epidemiology, an investigation of industrial hygiene in a chemical fibre corporation was carried out and the changes of the liver and kidney functions were analyzed among the workers who had been exposed to TPA, EG, DOW.
The values of serum gamma-glutamyl traspetidase(GGT) and total bile acid(TBA) in TPA + EG + DOW group men were (35.45 +/- 16.09) U/L, (10.29 +/- 6.76) mumol/L respectively and the values of serum alanine transaminase(ALT) and TBA in TPA + EG + DOW group women were(30.68 +/- 8.58) U/L, (9.53 +/- 6.63) mumol/L respectively, significantly higher than those in TPA, DOW and control groups(P < 0.05, P < 0.01). Compared with TPA, DOW and control groups, the values of urine N-acetyl-beta-D-glucosaminidase(NAG) and beta 2-2-microglobulim (beta 2-MG) in TPA + EG + DOW group of both men and women increased significantly(P < 0.05, P < 0.01), with(5.68 +/- 4.01) U/mmol Cr and (23.49 +/- 13.44) mg/mol Cr, and(6.68 +/- 4.68) U/mmol Cr and (22.80 +/- 13.00) mg/mol Cr, respectively. Analysis of regression indicated that both liver and renal injuries of the workers were evidently correlated with their exposure to TPA, EG and DOW after adjustment for the confounding factors such as sex, smoking, drinking, etc(P < 0.001).
Based on available knowledge, it is reasonable to assume that the joint actions should be considered on the injury of liver and kidney caused by TPA, EG and(or) DOW among the workers. Serum ALT, GGT, TBA, urine NAG and beta 2-MG should be suggested as biomarkers for liver and kidney damage.
研究接触对苯二甲酸（TPA）、乙二醇（EG）和（或）联苯醚（DOW）的工人的肝肾功能损伤情况，并探寻早期生物监测指标。
采用职业流行病学方法，对某化纤企业进行职业卫生调查，分析接触TPA、EG、DOW的工人的肝肾功能变化。
TPA + EG + DOW组男性血清γ-谷氨酰转肽酶（GGT）和总胆汁酸（TBA）值分别为（35.45 ± 16.09）U/L、（10.29 ± 6.76）μmol/L，TPA + EG + DOW组女性血清丙氨酸转氨酶（ALT）和TBA值分别为（30.68 ± 8.58）U/L、（9.53 ± 6.63）μmol/L，均显著高于TPA组、DOW组和对照组（P < 0.05，P < 0.01）。与TPA组、DOW组和对照组相比，TPA + EG + DOW组男性和女性尿N-乙酰-β-D-氨基葡萄糖苷酶（NAG）和β2-微球蛋白（β2-MG）值均显著升高（P < 0.05，P < 0.01），分别为（5.68 ± 4.01）U/mmol Cr和（23.49 ± 13.44）mg/mol Cr，以及（6.68 ± 4.68）U/mmol Cr和（22.80 ± 13.00）mg/mol Cr。回归分析表明，在调整性别、吸烟、饮酒等混杂因素后，工人的肝损伤和肾损伤均与接触TPA、EG和DOW显著相关（P < 0.001）。
基于现有知识，合理推测TPA、EG和（或）DOW对工人肝肾功能的损伤可能存在联合作用。建议将血清ALT、GGT、TBA、尿NAG和β2-MG作为肝肾功能损害的生物标志物。
