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目的通过对湖北省黄石市某有色金属冶炼厂周边地区镉污染暴露人群血、尿等生物样品的检测,在血镉、尿镉中筛选出能敏感反映镉性肾早期损伤的暴露指标。方法现场采集污染区389人和对照区居民260人的血液和尿液,检测血镉、尿镉、尿肌酐、尿β2-微球蛋白(β2-MG)及尿N-乙酰-B-D-氨基葡萄糖苷酶(NAG)等5项生物指标,以尿β2-MG及尿NAG酶二者之一超标为肾早期损伤阳性判断标准,通过接受者工作特征曲线(ROC)曲线下面积和Logistic回归模型的标准化偏回归系数来判断暴露指标血镉、尿镉的敏感性。结果649份样本中,血镉ROC曲线下面积(0.569,P<0.05)小于尿镉的ROC曲线下面积(0.725,P<0.05);相对肾早期损伤,尿镉的标准化偏回归系数(0.5036)大于血镉(-0.0212)。结论对于肾早期损伤的判断,暴露指标尿镉优于血镉。
OBJECTIVE: To detect the blood, urine and other biological samples of cadmium exposed people in a surrounding area of a nonferrous metal smelter in Huangshi City, Hubei Province, and to screen out the exposure indexes that can sensitively reflect the early injury of cadmium in blood and cadmium. Methods The blood and urine of 389 residents in the contaminated area and 260 residents in the control area were collected on site for detection of serum cadmium, urinary cadmium, urinary creatinine, urinary β2-microglobulin (β2-MG) and urine N-acetyl-BD-glucosamine NAG and other 5 biological indexes. The urinary β2-MG and urinary NAG enzyme were both regarded as the criterion of the positive judgment of early renal injury. The area under the receiver operating characteristic curve (ROC) curve and Logistic regression model Standardized partial regression coefficient to determine the exposure indicators of blood cadmium, urine cadmium sensitivity. Results The area under the ROC curve (0.569, P <0.05) of blood cadmium in 649 samples was less than the area under the ROC curve of urine cadmium (0.725, P <0.05). The standardized partial regression coefficient (0.5036) Greater than blood cadmium (-0.0212). Conclusion For the judgment of early renal injury, urine cadmium exposure index is better than blood cadmium.