三氯乙烯药疹性皮炎患者血清肿瘤坏死因子和表皮生长因子水平及其临床意义

目的　探讨三氯乙烯药疹性皮炎患者血清肿瘤坏死因子 (TNF α)和表皮生长因子(EGF)水平及临床意义。方法　清晨抽取空腹三氯乙烯药疹性皮炎 (DMLT)患者和正常对照人群静脉血液 ,分离血清 ,应用放射免疫分析法同时测定血清中TNF α以及EGF含量。结果　 39例DMLT患者血清TNF α含量为 (0 .2 78± 0 .0 92 )ng/L ,EGF含量为 (6 .71± 2 .2 8) μg/L ,两者各自与对照组(0 .12 8±0 .0 2 9)ng/L、(4.31± 1.13) μg/L]比较 ,差异均有显著性 (P <0 .0 5 ,P <0 .0 1)。结论　DMLT患者血清TNF α和EGF水平明显比正常人水平增高 ,其增高原因可能与下列因素有关 :(1)三氯乙烯及其代谢产物刺激体内的巨噬细胞、单核细胞等分泌TNF α ,并介导、启动机体炎症损害。 (2 )上皮组织严重受损 ,刺激体内合成更多的EGF ,以加速上皮组织的再生与修复。

The level of serum tumor necrosis factor-α and epidermal growth factor in patients with medicamentlike dermatitis by trichloroethylene and its clinical significance

OBJECTIVE: To investigate the level of tumor necrosis factor alpha (TNF-alpha) and epidermal growth factor (EGF) in patients with medicament-like dermatitis by trichloroethylene (DMLT). METHODS: Using radioimmunoassay methods, serum TNF-alpha, EGF were measured in 39 patients with DMLT and in 20 controls. RESULTS: The levels of serum TNF-alpha, EGF in patients with DMLT (0.278 +/- 0.092) ng/L, (6.71 +/- 2.28) microg/L, respectively] were significantly higher than those of the controls (0.128 +/- 0.029) ng/L, (4.31 +/- 1.13) microg/L respectively, P<0.05, P<0.01]. CONCLUSION: The increased levels of serum TNF-alpha, EGF in patients with DMLT may be related to the following causes: (1) Trichloroethylene and its metabolite may irritate the macrophagocyte and monocyte in human body to release TNF-alpha into blood stream; (2) Severe damage of epithelial tissue in patients with DMLT may promote more EGF synthesis to accelerate the regeneration and repair of epithelial tissue.