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目的探讨聚氨酯合成革业二甲基甲酰胺(DMF)对作业工人肝肾损害与脂代谢的影响。方法选择某聚氨酯合成革厂作业工人260名为对象,根据各岗位连续3 d空气DMF浓度监测结果,计算时间加权平均(TWA)浓度,分为高浓度接触组(TWA>55mg/m~3)、中浓度接触组(TWA 15～45mg/m~3)、低浓度接触组(TWA 2-10 mg/m~3)和对照组。测定血清中丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、γ-谷氨酰转肽酶(γ-GT)、碱性磷酸酶(ALP)、血清总胆红素(STB)、总胆固醇(CHO)、三酰甘油(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)和尿β_2-微球蛋白(β_2-MG)。结果接触组工人自述恶心19.31%、腹痛15.45%、腹胀13.73%、食欲减退9.01%;接触组肝功能ALT、AST、γ-GT异常检出率分别为34.33%、37.33%和38.20%;肝功能指标ALT、AST、γ/-GT在高、中、低各组间比较,差异有统计学意义(P<0.05);高浓度接触组尿β_2-MG和血清HDL检出值高于其他组别,差异有统计学意义(P<0.05)。结论DMF主要靶器官为肝脏,对肝功能的损害存在明显的剂量-反应关系;高浓度接触可对肾功能产生损害,对脂代谢可能产生一定的影响。
Objective To investigate the effect of dimethylformamide (DMF) on urethane synthetic leather on hepatic and renal damage and lipid metabolism in workers. Methods A total of 260 working workers in a polyurethane synthetic tannery were selected. According to the monitoring results of DMF concentration in air for 3 consecutive days in each post, the TWA concentration was calculated and divided into high concentration exposure group (TWA> 55mg / m ~ 3) (TWA 15 ~ 45mg / m ~ 3), low concentration exposure group (TWA 2-10 mg / m ~ 3) and control group. Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyl transpeptidase (γ-GT), alkaline phosphatase (ALP), serum total bilirubin (STB) , Total cholesterol (CHO), triglyceride (TG), high density lipoprotein (HDL), low density lipoprotein (LDL) and urinary β_2-microglobulin (β_2-MG) Results The workers in the exposure group reported 19.31% of nausea, 15.45% of abdominal pain, 13.73% of abdominal distension and 9.01% of loss of appetite. The detection rates of abnormal ALT, AST and γ-GT in the contact group were 34.33%, 37.33% and 38.20% The indexes of ALT, AST, γ / -GT in the high, middle and low groups were significantly different (P <0.05); the detection value of urinary β_2-MG and serum HDL in high concentration exposure group was higher than other groups , The difference was statistically significant (P <0.05). Conclusion The main target organ of DMF is liver, and there is a significant dose-response relationship between the damage of liver function and DMF. Exposure to high concentration of DMF may damage renal function and may affect lipid metabolism.