中文摘要：

目的探讨甲苯二异氰酸酯（TDI）职业暴露对血清中基质金属蛋白酶-9（MMP-9）和金属蛋白酶组织抑制剂-1（TIMP-11水平的影响及其与肺功能的相关性。方法采用横断面研究设计，于2014年10月，以整群抽样方法选择我国西部地区某TDI生产厂的作业T人为暴露组，共61名，纳人工种包括装桶T、巡检T、制造T。根据各工种外暴露浓度的不同，将装桶工归为高暴露组，巡检工和操作工归为低暴露组。另根据年龄、性别匹配原则，选择该工厂内与暴露组工人工作强度相似但不接触TDI及其他致敏物质的企业管理人员作为对照组，共计58名。通过问卷调查获取调查对象性别、年龄、工龄、吸烟及饮酒情况、个人及家族过敏史、职业史及近期患病情况。用8h加权平均浓度（8h-TwA）表示TDI空气中外暴露水平。采用ELISA检测血清中MMP-9和TIMP—1的水平，采用便携式肺功能仪测定用力肺活量（FVC）、第一秒用力呼气容积（FEV1．0）。采用Spearman相关分析法分析MMP-9、TIMP-1、MMP-9／TIMP-1与FVC、FEV1．0及工龄的关系。结果暴露组调查对象作业场所空气中TDI8h．TWA的平均值为0．39mg／m3，其中，装桶工为0．76mg／m3，操作工和巡检工均为0．25mg／m3。对照组、低暴露组及高暴露组血清中MMP-9的水平分别为（807．21±347．70）、（586．91±317．50）、（388．94±312．01）ng／ml（Z2=16．69，P〈0．001）；MMP-9／TIMP-1的P50（P25-P75）分别为4．67（2．87～6．68）、2．3（1．44～3．481、1．11f0．59—1．48）（22=39．42，P〈0．001）；TIMP-1分别为（173．44±72．67）、（236．12±51．98）、（302．81±44．39）ng／ml（F=20．09，P〈0．001）。暴露组中肺功能FVC、FEV1．0和FEV1．0／FVC的P50（P25～P75）分别为92．8％（86．0％～101．8％）、85．5％（76．7％～92．8％）和112．5（108．2～118．5），均低于对照组[124．3％（107?

英文摘要：

Objective To investigate the effect of occupational toluene diisocyanate（TDI） exposure on matrix metalloproteinases-9 （MMP-9）and tissue inhibitor of metalloproteinase-1 （TIMP-1）, and analysis of the correlation of MMP-9,TIMP-1,MMP-9/TIMP-1 and lung function. Methods In October 2014, based on cluster sampling, we conducted a cross-sectional study in a TDI production factory located in China＇s western region. 61 exposed workers were recruited from workers engaged in packing, operating and checking. Based on different levels of the external exposure, the packers were classified as high exposed group, while operators and checkers as low exposed group. 58 factory managers, matching age and agent, were selected as controls, having same work intense and not contacting the TDI or other allergens. The questionnaire surveys were used to obtain the agent, age, work age, smoking and drinking, personal and family allergic history, occupational history, and the recent health conditions. The levels of MMP-9 and TIMP-1 in serum of subjects were determind by ELISA. The time weighted average concentrations （8h-TWA） were used to describe the levels of TDI air exposure in working environment. Spearman correlation assay was used to investigate the correlation of MMP-9, TIMP-1, MMP-9/TIMP-1 and lung function, exposure time. Results 8-hour TWA means of TDI air levels in exposed group, packers, operators and checkers were 0.39, 0.76, 0.25 mg/m3, respectively . According to the external exposure concentration, the packers were classified as high exposed group, and the operators and checkers were classified as low exposed group. In controls, low exposed group and high exposed group, the levels of MMP-9, respectively, were（807.21±347.70）, （586.91±317.50）,（388.94±312.01） ng/ml（x2=16.69, P〈0.001）, respectively, and the Pso（P25-P75） of MMP-9/TIMP-1 were 4.67（2.87-6.68）, 2.3（1.4-3.48）, 1.11（0.59-1.48）（22=39.42, P〈0.001）, respectively, and the concentrations of TIMP- 1, were （ 173.4