[Staging of occupational medicamentosa-like dermatitis due to trichloroethylene].
[Staging of occupational medicamentosa-like dermatitis due to trichloroethylene].
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DOI：
10.3760/cma.j.cn121094-20190624-00229
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发表时间：
2020-06-20
影响因子：
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通讯作者：
Huang, X Q
中科院分区：
文献类型：
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作者：
Lin, D F;Xie, J W;Huang, X Q
目的：探讨职业性三氯乙烯药疹样皮炎（OMDT）一般病程的分期，以更好地了解OMDT的病程特点，为临床诊治及相关研究提供参考。研究方法：我们收集了2014年1月至2018年12月期间住院的35例有完整病程记录的OMDT患者住院至2019年5月期间的主要临床表现和辅助检查数据。选取主要临床表现指标、外周血白色细胞计数、肝功能指标如血清丙氨酸氨基转移酶活性、心肌酶指标如血清乳酸脱氢酶活性等有变化趋势的连续监测指标，并以其标准化值对每例患者病程的时间点（以周为单位）进行聚类分析。根据聚类结果结合指标变化趋势确定每例患者的病程分期，进而计算OMDT的一般病程分期。比较各期指标的阳性率或平均水平，分析各期病程与患者体质特征、疾病特征及治疗措施的相关性。结果如下：OMDT的一般病程可分为急性期（3.0±1.5）周和慢性期（11.0±4.4）周，慢性期又可分为早期（5.0±3.0）周和晚期（6.5±3.7）周。与慢性期相比，临床表现指标、白色细胞计数（除嗜酸性粒细胞计数外）、肝功能指标（除总蛋白和白蛋白浓度外）、心肌酶指标均升高（均P
Objective: To explor staging of the general course of occupational medicamentosa-like dermatitis due to trichloroethylene (OMDT) to better understand the characteristics of OMDT course, and to provide reference for clinical diagnosis and treatment and related studies. Methods: We collected main clinical manifestation and auxiliary examination data during hospitalization to May 2019 from 35 OMDT patients with complete course record who were hospitalized from January 2014 to December 2018. Continuous monitoring indicators with changing trends including main clinical manifestation indicators, peripheral white blood cell counts, liver function indicators such as serum alanine aminotransferase activity, myocardial enzyme indicators such as serum lactate dehydrogenase activity were selected and used with their standardized values to do cluster analysis on time point (week as unit) of the course of each patient. The clustering results combined with changing trends of the indicators were used to determine the stages of course of each patient, and therefore the staging of general course of OMDT was calculated. Positive rates or average levels of the indicators were compared between different stages, and the correlation of duration of each stage was analyzed with physical characteristics, disease characteristics and treatment measures of the patients. Results: General course of OMDT could be divided into acute phase (3.0±1.5) weeks and chronic phase (11.0±4.4) weeks, while chronic phase could be further divided into early period (5.0±3.0) weeks and later period (6.5±3.7) weeks. Compared with chronic phase, clinical manifestation indicators, white blood cell counts (except eosinophil count) , liver function indicators (except total protein and albumin concentration) , and myocardial enzyme indicators were all increased (all P