【文章內(nèi)容簡介】 showed case groupexposed groupunexposed control group, and the difference was significant (P). In case group, PF protein in peripheral lymphocyte is higher than exposed group and unexposed group(P), no significant difference between exposed group and unexposed group(P). It indicate CTL (CD4+CTL and CD8+CTL) induce apoptosis of effector cells in healthy TCEexposed workers. However, in cases, some CTLs are removed through Fas/FasL pathway, others migrate to skin, liver, kidney, etc, and mediated the target cell apoptosis. Meanwhile, the high expression of PF and GrB cause skin damage in cases.In case group the expression of FAS mRNA is higher than exposed( fold) and unexposed group( fold), exposed group is lower than unexposed group( fold)。 In case group the expression of FasL mRNA is higher than exposed( fold) and unexposed group( fold), exposed group is lower than unexposed group( fold)。 In case ( fold)and exposed group ( fold)the expression of PF mRNA are lower than unexposed group, in case group ( fold)is higher than unexposed group. In case group the expression of GrB mRNA is lower than exposed( fold) and unexposed group( fold), exposed group( fold) is higher than unexposed group. The expression of FAS, FASL, PF, GrB in protein and mRNA level are not identical, that is due to the expression of mRNA in transcription and translation are regulated by various factors.2. 8 cases report of DMLTCompare the differences of DMLT when hospitalized and liver function recovered to normal, further explore the indexes of immunological changes and that could be used to evaluate the clinical treatment effect, and bining with the former group analysis to analyze the relationship between immunological indexes and DMLT.Ⅰ.Analysis of lymphocyte subsetsThere are lymphocyte results of six patients when hospitalized and liver function recovered to normal. NEUT in 6 cases(100%) were higher when checked into hospital。 104 in 6 cases(%)had a higher EO than normal clinical range。 3 in 6(50%) cases had a higher BASO and LYMPH than normal clinical range. 6 cases(100%) had higher NEUT and BASO, 5 cases in 6 had higher LYMPH、MONO and EO when hospitalized than liver function recovered to normal. Those indicate immune function disorder in DMTL, all consistent with the former results.Lymphocyte subsets analysis results of six patients in hospital and liver back to normal, 4 cases (%)in 6 have significantly higher T lymphocytes in admission。 B lymphocytes, 3 cases (50%) was obviously higher than normal liver, 4 cases (%) NK cell below normal liver. On admission, 4 cases (%) CD4+T lymphocyte increased obviously, 4 cases (%) CD8+T lymphocytes increased obviously. In 3(50%)cases CD8+CD28+T below in admission, 5 cases (%) CD8+CD28T higher than liver back to normal. 4 patients in 6 patients (%) CD4+/CD8+ ratio decreased when hospitalized, 4 cases CD28+/CD28 cell ratio decreased. It indicated there are changes of immune cells number and proportion onset of DMLT.Case 1, 5, and 6 discharged from hospital when the liver function returning to normal. NK cells elevated、 CD28+CD8T cells reduced and the ratio of CD4+/CD8+ returned to normal in 3 patients when discharged from hospital. Those three indexes could be the index of rehabilitation. In case 1 and case 6, T lymphocytes、CD8 +T lymphocytes declined when discharged from hospital, it might be a reference index of rehabilitation.Ⅱ.Examination of Fas/FasL、PF/GrB expression of protein and mRNA in peripheral blood 4 patients in 6 (50%) the percentage of Fas+CD4+T cells in CD4+T were higher when hospitalized 、3 patients (50%) patients the percentage of FAS+CD8+Tcells in CD8+T were higher at admission than normal liver function, 3 patients in 6 (50%) the percentage of FasL+CD4+T cells in CD4+T were lower, 3 cases (50%) the percentage of FasL+CD8+T cells in CD8+T were lower than rehabilitation. Those results are consistent with the former results.11PF protein in peripheral lymphocyte was higher in 3 cases(100%) when hospitalized than liver function recovered to normal。 1 in 3 cases(%) GrB protein in peripheral lymphocyte was higher when hospitalized than liver function recovered to normal. It indicated PF damage skin keratinized cell at the early stage of DMLT.In summary, this study revealed the immune response in DMLT might induced by the metabolites of TCE rather than TCE itself. There were great changes in DMLT about lymphocyte subsets in peripheral blood. Lymphocyte, T cell, CD4+T cell could be disease markers of DMLT, CD8+T, CD8+CD28 T and NK cell could be effect makers for TCE exposure. CTLs take part in the damage of skin 、liver 、kidney and some other ans. Those results could make some significance to health surveillance of TCE exposure and provide possibility for further studies in pathogenesis.Key words: trichloroethylene，cellmediated immunity，drug rash，allergic contact dermatitis，hapten，cytotoxic T lymphocyte，Lymphocyte subsets, occupational exposure12英文縮寫詞表（List of Abbreviation）ACD allergic aminotransferase 過敏性接觸性皮炎AD Atopic dermatitis 特應(yīng)性皮炎ADH alcohol dehydrogenase 醇脫氫酶ALT glutamicpyruvic transaminase 谷丙轉(zhuǎn)氨酶ALDH aldehydedehydrogenase 醛脫氫酶AST glutamicoxaloacetic transaminase 谷草轉(zhuǎn)氨酶BASO basophils 嗜堿性粒細(xì)胞CD cluster of differentiation 分化抗原CHS Contact hypersensitivity 接觸性超敏反應(yīng)CTL cytotoxic T lymphocyte 細(xì)胞毒性 T 細(xì)胞CYP450 Cytochtome P450 細(xì)胞色素 P450 酶系DCVG (1,2dichlorovinyl)glutathione 1,2二氯乙烯基谷胱甘肽DCVC (1,2dichlorovinyl)Lcysteine 1,2二氯乙烯基半胱氨酸DMLTDermatitis medicamentosalike of trichloroethylene三氯乙烯藥疹樣皮炎DMSO dimethylsulfoxide 二甲基亞砜EDTA Disodium thylenediamietra acetate 乙二胺四乙酸EO eosnophils 嗜酸性粒細(xì)胞FASL fas ligand 外周血淋巴細(xì)胞13FCS fetal calf serum 胎牛血清GGT glutamine transferase 谷氨酰胺轉(zhuǎn)移酶GrB granzyme B 顆粒酶 BGSH glutathione 谷胱甘肽GSTs Glutathione Stranferase 谷胱甘肽轉(zhuǎn)移酶