Franco G, Fonte R
GF. Cattedra di Medicina del lavoro dell'Università di Modena, Italy.
Occup Med (Lond). 1994 Feb;44(1):12-6. doi: 10.1093/occmed/44.1.12.
The contribution of operating theatre work to specific diseases is still a controversial matter involving a variety of risk factors. The concept that the liver plays a central role in anaesthetics biotransformation stimulated numerous studies aimed at establishing the occurrence of liver changes and at verifying the relationship between liver disease and anaesthetics. The liver microsomal enzyme system has received particular attention in order to clarify the mechanism involved in anaesthetics hepatotoxicity and an increased microsomal activity has been detected in experimental conditions and in humans. In particular, a significant increase in the excretion of urinary D-glucaric acid (UDGA) in subjects occupationally exposed to anaesthetic mixture was observed. Nevertheless, few results exist about the relationship between UDGA increase and environmental anaesthetic concentration, and mechanisms responsible for UDGA increase still need to be clarified. Attention is focused, however, on the possibility of using UDGA as an index reflecting an adaptation effect (rather than an injury effect), which may represent a more adequate approach for evaluating any change related to working in the operating theatre.
手术室工作对特定疾病的影响仍是一个存在争议的问题，涉及多种风险因素。肝脏在麻醉药物生物转化中起核心作用这一概念激发了众多研究，旨在确定肝脏变化的发生情况，并验证肝脏疾病与麻醉药物之间的关系。为了阐明麻醉药物肝毒性所涉及的机制，肝脏微粒体酶系统受到了特别关注，并且在实验条件下和人体中均检测到微粒体活性增加。特别是，观察到职业性接触麻醉混合气体的受试者尿中D - 葡糖醛酸（UDGA）排泄量显著增加。然而，关于UDGA增加与环境麻醉浓度之间的关系，现有结果很少，且导致UDGA增加的机制仍有待阐明。不过，人们关注的焦点在于将UDGA用作反映适应效应（而非损伤效应）指标的可能性，这可能是评估与手术室工作相关的任何变化的更合适方法。
