Deng L D, Deng L H, Lin D F, Tang H Y, Wang D P, Luo B, Tong X D, Zhang W
Medical Laboratory of Shenzhen Prevention and Treatment Center for Occupational Diseases, Shenzhen 518010, China.
Occupational Disease Department of Shenzhen Prevention and Treatment Center for Occupational Diseases, Shenzhen 518010, China.
Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2020 Oct 20;38(10):731-735. doi: 10.3760/cma.j.cn121094-20200407-00172.
To investigate the changes in liver function and peripheral regulatory lymphocytes before and after treatment in patients with occupational medicamentosa-like dermatitis due to trichloroethylene (OMDT) . In December 2019, 16 patients with OMDT (8 patients with erythema multiforme and 8 with erythema multiforme major) who were admitted from February 2017 to February 2019 were enrolled as subjects. Liver function parameters and percentages of peripheral regulatory lymphocytes were measured before and after treatment, and the changes in liver function and peripheral regulatory T and B lymphocytes and their correlation were analyzed. Before treatment, compared with the healthy control group, the experimental group had significantly higher levels of alanine aminotransferase (ALT) , aspartate aminotransferase (AST) , total bilirubin (TBIL) , direct bilirubin (DBIL) and gamma-glutamyl transpeptidase (GGT) and significantly lower levels of total protein (TP) , albumin (ALB) and cholinesterase (CHE) (<0.05) . Compared with the healthy control group, the experimental group had significantly lower percentages of lymphocytes, CD4(+) T cells, CD4(+)CD25(+) Tregs, CD19(+)CD24(+)CD27(+) Bregs and CD4(+)/CD8(+) ratio, as well as a significantly higher percentage of CD8(+) T cells (<0.05) . Before treatment, the levels of ALT, AST, GGT and DBIL were negatively correlated with the percentages of CD4(+)CD25(+) Tregs, CD19(+)CD24(+)CD27(+) Bregs, CD4(+) T cells and CD4(+)/CD8(+) ratio (=-0.386 to -0.809, <0.05) and was positively correlated with the percentage of CD8(+) T cells (except DBIL) (=0.503-0.568, <0.05) . The levels of TP and ALB were positively correlated with the percentages of CD4(+)CD25(+) Tregs, CD19(+)CD24(+)CD27(+)Bregs and CD4(+) T cells (= 0.351-0.784, <0.05) , ALB was negatively correlated with the percentage of CD8(+) T cells (=-0.315, <0.05) . CHE was positively correlated with the percentages of CD4(+)CD25(+) Tregs, CD19(+)CD24(+)CD27(+)Bregs and CD4(+)/CD8(+) ratio (=0.390-0.527, <0.05) . Immune dysfunction is observed in patients with OMDT, which may be caused by the imbalance of regulatory lymphocytes. And liver injury may be associated with the increase of CD8(+) T cells and the reductions of percentages of CD4(+) T cells, CD4(+)CD25(+) Tregs, CD19(+)CD24(+)CD27(+)Bregs and CD4(+)/CD8(+) ratio.
探讨三氯乙烯所致职业性药疹样皮炎（OMDT）患者治疗前后肝功能及外周调节性淋巴细胞的变化。选取2017年2月至2019年2月收治的16例OMDT患者（8例多形红斑型和8例重症多形红斑型）作为研究对象。检测治疗前后肝功能指标及外周调节性淋巴细胞百分比，分析肝功能及外周调节性T、B淋巴细胞的变化及其相关性。治疗前，与健康对照组相比，实验组丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、总胆红素（TBIL）、直接胆红素（DBIL）和γ-谷氨酰转肽酶（GGT）水平显著升高，总蛋白（TP）、白蛋白（ALB）和胆碱酯酶（CHE）水平显著降低（<0.05）。与健康对照组相比，实验组淋巴细胞、CD4(+)T细胞、CD4(+)CD25(+)调节性T细胞（Tregs）、CD19(+)CD24(+)CD27(+)调节性B细胞（Bregs）百分比及CD4(+)/CD8(+)比值显著降低，CD8(+)T细胞百分比显著升高（<0.05）。治疗前，ALT、AST、GGT和DBIL水平与CD4(+)CD25(+)Tregs、CD19(+)CD24(+)CD27(+)Bregs、CD4(+)T细胞百分比及CD4(+)/CD8(+)比值呈负相关（r=-0.386至-0.809，<0.05），与CD8(+)T细胞百分比呈正相关（DBIL除外，r=0.503-0.568，<0.05）。TP和ALB水平与CD4(+)CD25(+)Tregs、CD19(+)CD24(+)CD27(+)Bregs和CD4(+)T细胞百分比呈正相关（r=0.351-0.784，<0.05），ALB与CD8(+)T细胞百分比呈负相关（r=-0.315，<0.05）。CHE与CD4(+)CD25(+)Tregs、CD19(+)CD24(+)CD27(+)Bregs和CD4(+)/CD8(+)比值呈正相关（r=0.390-0.527，<0.05）。OMDT患者存在免疫功能紊乱，可能由调节性淋巴细胞失衡所致。肝损伤可能与CD8(+)T细胞增多及CD4(+)T细胞、CD4(+)CD25(+)Tregs、CD19(+)CD24(+)CD27(+)Bregs百分比及CD4(+)/CD8(+)比值降低有关。
