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目的研究慢性汞暴露对人群肾脏功能的影响。方法于2007年选择某温度计厂职工为研究对象,以该厂1996—2006年生产车间空气汞监测历史数据划分对照组(85人)和暴露组(101人),检测发汞、尿汞、累积暴露量(CEI)、肾小球滤过功能及肾小管吸收功能。结果暴露组空气汞浓度、尿汞、发汞和累计暴露量均显著高于对照组(P<0.01),两组间血肌酐(Scr)和内生肌酐清除率(Ccr)的差异有统计学意义(P<0.01),暴露组尿N-乙酰-β-D葡萄糖苷酶(NAG)活力显著高于对照组(P<0.05),而传统肾脏损害指标血尿素氮(Bun)、α1-微球蛋白(α1-MG)和尿视黄醇结合蛋白(RBP)组间差异不明显(P>0.05);多元分析结果显示随发汞的升高,Scr显著升高,Ccr显著降低;NAG活力与尿汞呈显著正相关。结论慢性汞暴露可造成肾功能的损害,监测人群慢性汞暴露致肾脏损害时,Scr和Ccr可作为肾小球功能损伤的敏感效应指标,尿NAG可作为肾小管功能损害的敏感效应指标。
Objective To study the effect of chronic mercury exposure on renal function in the population. Methods A thermometer factory worker was selected as the research object in 2007, and the control group (85 persons) and the exposure group (101 persons) were divided according to the historical data of mercury monitoring in the workshop during 1996-2006. The mercury, mercury and mercury Exposure (CEI), glomerular filtration and renal tubular absorption. Results The concentrations of mercury, urinary mercury, mercury and total exposure in the exposed group were significantly higher than those in the control group (P <0.01). There was a statistically significant difference between the two groups in the levels of serum creatinine (Scr) and endogenous creatinine clearance (Ccr) (P <0.01). The activity of urine N-acetyl-β-D-glucosidase (NAG) in exposed group was significantly higher than that in control group (P <0.05) There was no significant difference between globulin (α1-MG) and urinary retinol binding protein (RBP) (P> 0.05). Multivariate analysis showed that Scr was significantly increased and Ccr was significantly decreased with the increase of mercury; NAG activity There was a significant positive correlation with urinary mercury. Conclusion Chronic mercury exposure may cause renal damage. Scr and Ccr can be used as sensitive indicators of glomerular dysfunction in monitoring renal damage caused by chronic mercury exposure. Urinary NAG can be used as a sensitive indicator of renal tubular dysfunction.