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目的探讨某鞋厂苯接触工人血小板参数变化及其影响因素的前瞻性研究。方法采用前瞻性研究设计,研究对象为某鞋厂新员工从事苯接触工作,到本中心参加职业健康体检者共84例。在研究对象刚参加工作,苯接触1年、2年、3年,分别检查血常规五分类,含血小板计数、血小板分布宽度、血小板平均容积、大血小板比率、以及血小板压积。应用重复测量资料分析方法探讨各血小板参数在每个检查时点的变化趋势,并通过协方差分析探讨血小板参数的影响因素。结果随着苯接触时间延长,血小板计数呈下降趋势,从基线(209.60±40.49)×109/L下降至第3年末的(183.96±63.90)×109/L,以第1年变化最显著(P<0.001);血小板压积(0.18±0.09%升至0.25±0.09%)、血小板平均容积(10.48±0.72 fl升至11.02±0.75 fl)、血小板分布宽度(12.63±1.47 CV%升至14.22±2.07 CV%)逐渐上升(P<0.001),但是第1年末至第2年末期间变化趋势无统计学意义(P>0.05);大血小板比率(29.16±5.47%升至35.65±5.69%)呈上升趋势,有统计学意义(P<0.001)。协方差分析提示,年龄越大、苯和甲苯接触剂量越高,血小板计数随之减少,血小板压积、血小板平均容积、血小板分布宽度,大血小板比率随之增大(P<0.05)。结论对于苯接触人群,血小板参数会随苯接触时间而发生变化,与年龄、苯接触剂量密切相关,应采取有效措施做好慢性苯中毒的三级预防。
Objective To investigate the prospective study of platelet parameters and its influencing factors in benzene-exposed workers in a shoe factory. Methods A prospective study design was conducted. The study was conducted on benzene exposure to a new employee in a shoe factory. There were 84 cases of occupational health examination in our center. Participants in the study just joined the work, benzene exposure to 1 year, 2 years, 3 years, respectively, check the blood five categories, including platelet count, platelet distribution width, average platelet volume, large platelet ratio, and platelet pressure. Repetitive measurement data analysis method was used to explore the change trend of each platelet parameter at each examination point, and the influencing factors of platelet parameters were analyzed by covariance analysis. Results With the prolongation of benzene exposure, the platelet count showed a decreasing trend from baseline (209.60 ± 40.49) × 109 / L to (183.96 ± 63.90) × 109 / L at the end of the third year, with the most significant change in the first year (P <0.001). The values of platelet pressure (0.18 ± 0.09% to 0.25 ± 0.09%), mean platelet volume (10.48 ± 0.72 fl to 11.02 ± 0.75 fl) and platelet width (12.63 ± 1.47 CV% to 14.22 ± 2.07 CV%) increased gradually (P <0.001), but there was no significant difference between the end of the first year and the end of the second year (P> 0.05). The rate of large platelet increased from 29.16 ± 5.47% to 35.65 ± 5.69% , With statistical significance (P <0.001). Covariance analysis indicated that the older the higher the exposure dose of benzene and toluene, the lower the platelet count, the greater the platelet pressure, the average platelet volume, the distribution width of platelets and the ratio of large platelet (P <0.05). Conclusion For benzene exposure to human beings, the platelet parameters will change with the exposure time of benzene, and are closely related to the age and benzene exposure dose. Effective measures should be taken to make tertiary prevention of chronic benzene poisoning.