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目的应用职业流行病学资料估算铅接触引起肾功能损害的基准剂量。方法2002年4月至2003年5月,以血铅作为接触标志物,尿蛋白、尿N乙酰βD氨基葡萄糖苷酶(NAG)、尿β2微球蛋白(β2MG)作为效应标志物,将数据进行二分变量处理作为效应终点,采用基准剂量计算软件(BMDS1.3.1)计算基准剂量反应为10%时,各效应标志物的血铅基准剂量和基准剂量的95%可信区间下限(BMDL)。结果肾功能3项指标异常率随血铅水平增高而增高,存在剂量反应关系,其血铅的基准剂量为323.6～754.3μg/L,BMDL值为274.2～541.5μg/L,BMDL值大小依次为尿NAG、尿蛋白和尿β2MG,尿NAG是监测肾功能损害的最敏感指标。结论基准剂量法应用到各种毒物参考剂量和参考浓度的制定中具有可行性。
Objective To estimate the baseline dose of lead-induced renal dysfunction using occupational epidemiological data. Methods From April 2002 to May 2003, blood lead was used as a marker of exposure, urine protein, urine N-acetylglucosaminidase (NAG) and urinary β2-microglobulin (β2MG) The dichotomous variable treatment was used as the end point for the effect and the baseline dose response software (BMDS1.3.1) was used to calculate the 95% confidence interval lower bound (BMDL) for the baseline blood lead and reference doses for each effect marker at a 10% base dose response. Results The abnormal rate of 3 indexes of renal function increased with the increase of blood lead level. There was a dose-response relationship. The reference dose of blood lead was 323.6-754.3μg / L, BMDL was 274.2-541.5μg / L, BMDL value was Urine NAG, urinary protein and urinary β2MG, urinary NAG are the most sensitive indicators of renal damage. Conclusion The reference dose method is applicable to the formulation of reference doses and reference concentrations of various poisons.