甲苯二异氰酸酯职业暴露者外周血淋巴细胞亚群分析

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[目的]研究甲苯二异氰酸酯(TDI)对暴露工人外周血淋巴细胞亚群的影响,为探讨TDI的免疫毒性提供依据。[方法]采用横断面研究方式,以整群抽样法选取甘肃省TDI作业工人53名为暴露组,选取同地区非职业性TDI暴露工人55名为对照组。气相色谱法检测作业环境中TDI水平和尿中代谢产物甲苯二胺(TDA)浓度。应用流式细胞术检测外周血淋巴细胞亚群水平,并结合血常规中淋巴细胞总数的结果,计算CD3+T细胞、CD4~+T细胞、CD8~+T细胞、B细胞和NK细胞绝对数。[结果]暴露组尿中总TDA浓度M(P_(25)~P_(75))为15.86(7.91~29.99)μg/L。淋巴细胞亚群分析,对照组的淋巴细胞、CD3+T细胞、CD4~+T细胞、CD8~+T细胞、B细胞和NK细胞分别为1.80(1.40~2.30)×10~9/L、(1.24±0.35)×10~9/L、0.65(0.53~0.75)×10~9/L、0.47(0.35~0.57)×10~9/L、0.18(0.13~0.23)×10~9/L和0.23(0.19~0.31)×10~9/L。暴露组淋巴细胞、CD8~+T细胞和NK细胞分别为1.92(1.59~2.46)×10~9/L、0.54(0.40~0.67)×10~9/L和0.45(0.35~0.61)×10~9/L,暴露组高于对照组,差异有统计学意义(P<0.05)。依据尿中总TDA浓度中位数进行分组,低暴露组淋巴细胞、CD3+T细胞、CD4~+T细胞、CD8~+T细胞和NK细胞分别为2.13(1.84~2.45)×10~9/L、(1.42±0.34)×10~9/L、0.70(0.58~0.83)×10~9/L、0.60(0.53~0.69)×10~9/L和0.48(0.33~0.64)×10~9/L,高于对照组(P<0.05);高暴露组NK细胞为0.43(0.32~0.55)×10~9/L,高于对照组(P<0.05)。所有指标在低、高暴露组间差异无统计学意义(P>0.05)。暴露组TDI暴露工龄与淋巴细胞亚群的变化无相关(P>0.05)。[结论]TDI暴露可导致作业工人外周血淋巴细胞亚群发生变化,提示TDI职业暴露者免疫功能受到影响。 [Objective] To investigate the influence of tolylene diisocyanate (TDI) on the peripheral blood lymphocyte subsets in exposed workers and provide basis for exploring the immunotoxicity of TDI. [Method] The cross-sectional study was used to select 53 TDI workers in Gansu Province as the exposure group by cluster sampling method. 55 non-occupational TDI exposed workers in the same area were selected as the control group. Gas chromatography was used to determine the level of TDI in the working environment and the concentration of urinary metabolites toluenediamine (TDA). The level of lymphocyte subsets in peripheral blood was detected by flow cytometry and the absolute numbers of CD3 + T cells, CD4 + T cells, CD8 + T cells, B cells and NK cells were calculated in combination with the results of the total number of lymphocytes in blood . [Results] The total TDA concentration in the exposed group was 15.86 (7.91-29.99) μg / L, P (25) ~ P 75. Lymphocyte subsets analysis showed that the percentage of lymphocytes, CD3 + T cells, CD4 + T cells, CD8 + T cells, B cells and NK cells in control group were 1.80 (1.40-2.10) × 10-9 / 1.24 ± 0.35) × 10 ~ 9 / L, 0.65 (0.53 ~ 0.75) × 10 ~ 9 / L, 0.47 (0.35 ~ 0.57) × 10 ~ 9 / L and 0.18 (0.13 ~ 0.23) × 10 ~ 9 / L and 0.23 (0.19 ~ 0.31) × 10 ~ 9 / L. The numbers of CD8 ~ + T cells and NK cells in exposed group were 1.92 (1.59 ~ 2.46) × 10 ~ 9 / L, 0.54 (0.40 ~ 0.67) × 10 ~ 9 / L and 0.45 (0.35 ~ 0.61) × 10 ~ 9 / L, the exposure group was higher than the control group, the difference was statistically significant (P <0.05). According to the median of total TDA concentration in urine, the numbers of CD3 + T cells, CD4 + T cells, CD8 + T cells and NK cells in low exposure group were 2.13 (1.84-2.45) × 10-9 / L, 0.60 (0.53 ~ 0.69) × 10 ~ 9 / L and 0.48 (0.33 ~ 0.64) × 10 ~ 9 / L, higher than the control group (P <0.05). The NK cells in high exposure group were 0.43 (0.32-0.55) × 10-9 / L, higher than the control group (P <0.05). All indicators in the low and high exposure groups showed no significant difference (P> 0.05). There was no correlation between the length of TDI exposure and the change of lymphocyte subsets in exposed group (P> 0.05). [Conclusion] The exposure of TDI can lead to changes of peripheral blood lymphocyte subsets in workers, suggesting that the immune function of TDI exposed workers is affected.
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