Skarping G, Dalene M, Littorin M
Department of Occupational and Environmental Medicine, University Hospital, Lund, Sweden.
Int Arch Occup Environ Health. 1995;67(2):73-7. doi: 10.1007/BF00572229.
A 45-year-old mechanic employed in blowing hot air (350 degrees-600 degrees C) onto the surface of a polyurethane methylene diphenyl diisocyanate (MDI) conveyer belt developed dyspnoea, rhinoconjunctivitis and fever. The illness was suggestive of an MDI-associated illness, compatible with both immediate hypersensitivity and a complement-mediated immune-complex reaction. In his serum there were specific IgG and IgE antibodies against MDI and other isocyanates, and high values of circulating immune complexes. The patient's blood and urine samples were analysed for the presence of 4,4'-methylenedianiline (MDA) in hydrolysed urine and plasma. MDA was derivatized to amides using pentafluoropropionic acid anhydride (PFPA). Gas chromatography-mass spectrometry determinations were made monitoring the (M-20; M = molecular mass) fragments from the MDA-PFPA and the [2H2]MDA-PFPA derivative. The first urine sample was obtained 22 h and the last sample 114 h after start of exposure. The urine concentrations of MDA were corrected for creatinine. The half-time of MDA was 70-80 h. The first serum sample was obtained 19 h and the last sample 1967 days after the start of exposure. The half-time was 21 days, which suggests the presence of MDI/MDA plasma protein adducts in the exposed worker.
一名45岁的机械师,其工作是将热空气(350摄氏度至600摄氏度)吹到聚氨酯亚甲基二苯基二异氰酸酯(MDI)传送带上,他出现了呼吸困难、鼻结膜炎和发热症状。该疾病提示为与MDI相关的疾病,既符合速发型超敏反应,也符合补体介导的免疫复合物反应。其血清中存在针对MDI和其他异氰酸酯的特异性IgG和IgE抗体,以及高值的循环免疫复合物。对患者的血液和尿液样本进行分析,以检测水解尿液和血浆中4,4'-亚甲基二苯胺(MDA)的存在情况。使用五氟丙酸酐(PFPA)将MDA衍生化为酰胺。采用气相色谱-质谱法进行测定,监测MDA-PFPA和[2H2]MDA-PFPA衍生物的(M-20;M =分子量)碎片。在开始接触后的22小时采集了第一份尿液样本,最后一份样本在114小时采集。尿液中MDA的浓度以肌酐进行校正。MDA的半衰期为70至80小时。在开始接触后的19小时采集了第一份血清样本,最后一份样本在1967天后采集。半衰期为21天,这表明接触MDI的工人血浆中存在MDI/MDA血浆蛋白加合物。