手传振动对植物神经功能的影响

目的 探讨手传振动对作业工人植物神经功能的影响。方法 对54名金矿凿岩工人进行了振动负荷前后心率变异性的测试,并对其植物神经功能紊乱的表现进行了分析。结果 静息状态下振动负荷试验前、后,对照组、接振组、白指组SDANN均有依次降低、LF／HF均有依次增高的趋势,其中白指组变化更明显（P＜0．05,P＜0．01）;试验前后比较,试验后SDANN较试验前降低、试验后LF／HF较试验前增高,其中接振组与对照组的变化差异有显著性（P＜0．05、P＜0．01）。白指组,接振组植物神经功能紊乱表现的发生率高于或显著高于对照组（P＜0．01）;神经衰弱综合发生率、动脉收缩压白指组显著高于接振组（P＜0．05）。结论 手传振动可致植物神经功能紊乱,包括交感染神经兴奋性增高和迷走神经兴奋性降低,随接振时间的延长,这种紊乱有加重的趋势。     

振动性白指患者与不同接振时间工人心率变异性分析

将53名男性金矿凿岩工人分为白指组、接振A组（接振5年以上）、接振B组（接振5年以下），分别测定其心率变异性，并同对照组进行比较。结果表明，代表迷走神经功能的指标SDANN随接振时间的延长而减小（P＜0．05，P＜0．01），但白指组与接振A组间无差异；代表交感-迷走均衡性的指标LF／HF随接振时间的延长而增大（P＜0．05，P＜0．01），但白指组明显低于接振A组。提示，随接振时间的不断延长，局部振动造成的植物神经功能尤其交感神经功能呈现早期亢进、中晚期下降的变化过程。     

振动作业者手部冷水试验红外图像测温

[目的]利用红外摄像结合冷水试验了解手臂振动对手部周围循环功能的影响。[方法]通过对振动作业工人50名（接振组），非接振健康工人50名（对照组），在冷水负荷前后，用KY-333型远红外摄像仪进行手部红外摄像，对图像分析并进行对比。[结果]冷水试验前，两组工人手部红外图像差异无统计学意义（P〉0．05）；冷水试验后接振组手指皮肤温度较对照组下降，复温时间延长（P〈0．01）。[结论]振动作业对手部周围循环功能有影响，红外摄像结合冷水试验可作为检查方法之一。     

局部振动对周围神经与血管机能影响的研究

目的 探讨局部振动对作业工人周围神经、周围血管功能的影响。方法 对振动作业工人进行正中神经传导速度、动作电位波幅的测试,并通过１０℃、１０ｍｉｎ的冷水试验对作业工人手部皮肤温度的恢复情况进行了研究。结果 白指组正中神经的感觉神经、运动神经传导速度明显低于对照组（Ｐ〈０．０１）;冷水试验前后白指组的手部温度均显著低于接振组和对照组（Ｐ〈０．０１）,冷水试验后白指组、接振组的复温率均显著低于对照组（Ｐ     

末梢循环功能及末梢神经功能检查与局部振动病

本文通过１６２名局部振振动作业工人的末梢循环功能和末梢神经功能的检查，发现接振工人的基础皮温测定、冷水复温试验，手指阻抗血流图，两点辨识觉、振动觉、痛觉等项指标，经统计学处理表明：（１）多项指标与对照组之间有显著差异（Ｐ〈０．０５或Ｐ〈０．０１），振动性白指尤为明显；（２）振动性白旨的末梢循环功能和末梢神经功能同时受到损害，白指组的基础皮温与痛觉、波幅与两点辨别觉之间均存在正相关，ｒ分别为０．５１     

手部红外图像和冷水试验在手传振动病健康监护中的应用

目的 通过手部红外摄像和冷水试验检查,确定手传振动对手部周围循环功能的影响。方法 通过对振动作业工人50名（接振组）,非接振健康工人50名（对照组）,在冷水负荷前后,用KY-333型远红外摄像仪进行手部红外摄像,对图像进行对比分析。结果 冷水试验前,两组工人手部红外图像差异无统计学意义;冷水试验后,手部红外图像变化显著,接振组手指5、10 min皮肤温度显著低于对照组（P〈0.01）,复温时间延长。结论 尚未发生振动性白指的接振工人中已经出现冷水试验的手部红外图像变化,表明手部红外图像分析对周围循环功能障碍具有早期识别和亚临床意义。     

振动作业工人手部红外图像分析

目的研究振动作业人员手部红外摄像和冷水试验对手臂振动病周围循环功能的改变。方法通过对非接触振动的健康工人50名（对照组）、尚无发生振动性白指的振动作业工人50名（接振组）,在冷水负荷前后,用KY-333型远红外摄像仪进行手部红外摄像,研究手部周围循环功能的变化。结果冷水试验前两组工人手部红外图像差异无统计学意义（P〉0.05）;冷水试验后5 min和10 min接触振动组手指皮肤温度比对照组下降显著（P〈0.05和P〈0.01）,两组冷水试验后5min平均皮温分别为：右手（21.5±1.7）℃和（23.5±1.8）℃,左手（20.5±1.1）℃和（24.0±1.6）℃;接振组复温时间延长。结论手部红外摄像结合冷水试验对振动作业工人周围循环功能障碍具有早期识别意义。     

煤矿掘进工手部循环功能与血管内皮活性物质的关系

[目的]探讨手臂振动对手部循环功能的影响及其与血管内皮活性物质之间的关系。[方法]以煤矿男性井下掘进工64名作为研究对象,按累积接振时间的长短分为高暴露组、中暴露组和低暴露组,并选22名非接振的健康人作为对照组,对每组进行血管内皮物质和冷水负荷试验测定,分析二者之间的相关关系。[结果]3个振动暴露组内皮素（ET）浓度、血栓素B2（TXB2）浓度均明显高于对照组（P〈0．01）;该3个暴露组的一氧化氮（NO）浓度、6．酮前列腺素Flu（6-keto-PGF1α）浓度均明显低于对照组（P〈0．01）0冷水试验前高暴露组皮肤温度明显低于对照组（P〈0．01）,冷水负荷试验后3个暴露组在5、10、30min的皮肤温度明显低于相同时间的对照组（P〈0．01）。10min复温异常率、30min复温异常率在对照组、低暴露组、中暴露组、高暴露组间差异有统计学意义（P〈0．01）;且呈明显的剂量．效应关系。将各组血管内皮物质与5min复温率、10min复温率进行相关分析,可见复温率与ET、TXB2呈明显的正相关关系（P〈0．01）,而与NO、6-keto-PGF1α呈明显的负相关关系（P〈0.01）。[结论]振动性血管内皮物质紊乱与手部复温情况具有一致性,提示振动性血管功能紊乱可以作为振动性血管损伤的评价参考指标。     

手传振动对煤矿掘进工血浆内皮素、一氧化氮浓度的影响

以不同接振时间的64名煤矿掘进工进行了血浆内皮素、一氧化氮浓度的测定。结果表明,各个接振时间段内皮素浓度均高于对照组,并随接振时间的延长增高更明显（P＜0．05,P＜0．01）。在接振时间≤5000h时,一氧化氮浓度高于对照组,但无统计学意义（P＞0．05）;接振时间＞5000h,一氧化氮浓度低于对照组,且随接振时间延长,降低更明显（P＜0．05,P＜0．01）。表明手传振动可致煤矿掘进工血浆内皮素浓度的升高及一氧化氮浓度的下降,这种改变可能与振动性血管损伤有一定联系。     

振动负荷试验对振动作业工人脑干听觉诱发电位影响的研究

本文研究了振动性白指患者（白指组）、振动作业工人（接振组）振动负荷前后脑干听觉诱发电位（ＢＡＥＰ）的变化，并同对照组进行了比较。结果表明，振动负荷前后白指组ＢＡＥＰ的Ⅰ、Ⅲ、Ⅴ波潜伏期及各峰间期和接振组Ⅰ波潜伏期均较对照组明显延长（Ｐ＜００５，Ｐ＜００１）；白指组ＢＡＥＰ的Ⅰ、Ⅲ、Ⅴ波、各峰间期及接振组Ⅰ、Ⅴ波潜伏期在振动负荷后较振动负荷前明显缩短（Ｐ＜００５）。从而提示，振动可致脑干听通路受累，并使中枢神经系统对刺激的反应性下降；ＢＡＥＰ结合振动负荷试验对评价手传振动引起的中枢神经系统损害具有一定意义。     

手臂振动对心率变异性及外周循环功能影响的研究

探讨手臂振动对作业工人心率变异性与外周循环功能的影响及二者之间的关系。「方法」对某金矿凿岩工人进行了心率变异性的评价指标ＳＤＡＮＮ、ＬＦ／ＨＦ分析,并测试了冷水试验前后作业工人的皮肤温度以及试验后５ｍｉｎ、１０ｍｉｎ的复温度。结论手臂振动造成的外周循环功能障碍可能与植物神经功能紊乱有一定关系。     

Heart rate variation and serum dopamine-beta-hydroxylase activity in workers exposed to vibration

Tests of autonomic nervous function were conducted on 38 workers who had been exposed to vibration [16: VWF(+) group, 22: VWF(-) group, VWF: vibration-induced white finger] and 17 workers who had not been exposed to vibration (control group). Measurements were made of R-R interval variation of the electrocardiogram at rest and during deep breathing, and serum dopamine-beta-hydroxylase (DBH) activity during an immersion test of the hand in 10 degrees C water. Heart-rate variation related to respiratory arrhythmia indicates parasympathetic activity, and serum DBH activity is regarded as an indicator of sympathetic activity. The variations in the R-R interval during deep breathing were smallest in the VWF(+) group, followed by the VWF(-) group (P less than 0.05 and P less than 0.01, compared with the control group). The DBH activity of the VWF(+) group was larger than those of the VWF(-) group and the control group, however, the differences were small and not statistically significant. The reduced R-R interval variations in the VWF(+) and the VWF(-) groups support the hypothesis that autonomic nervous function can be affected by exposure to vibration. The change of DBH activity induced by cold exposure may be an unsuitable index of sympathetic tone. Further study of the autonomic nervous function in workers with vibration syndrome is recommended.     

A longitudinal study of finger systolic blood pressure and exposure to hand-transmitted vibration

Objectives

To investigate prospectively the relation between vibration-induced white finger (VWF), exposure to hand-trasmitted vibration (HTV) and the cold response of digital arteries in users of vibrating tools.

Methods

Two-hundred and sixteen HTV workers and 133 control men of the same companies underwent initially a medical examination and a standardised cold test with measurement of the change in finger systolic blood pressure (FSBP) after finger cooling from 30 to 10°C. They were re-examined 1 year later. Tool vibration magnitudes were expressed as frequency-weighted and unweighted r.m.s. accelerations. From the vibration magnitudes and exposure durations, alternative measures of cumulative vibration dose were calculated for each HTV worker, according to the expression: $ \text{dose} = \sum a_i^m t_iObjectives To investigate prospectively the relation between vibration-induced white finger (VWF), exposure to hand-trasmitted vibration (HTV) and the cold response of digital arteries in users of vibrating tools. Methods Two-hundred and sixteen HTV workers and 133 control men of the same companies underwent initially a medical examination and a standardised cold test with measurement of the change in finger systolic blood pressure (FSBP) after finger cooling from 30 to 10°C. They were re-examined 1 year later. Tool vibration magnitudes were expressed as frequency-weighted and unweighted r.m.s. accelerations. From the vibration magnitudes and exposure durations, alternative measures of cumulative vibration dose were calculated for each HTV worker, according to the expression: , where a _i is the acceleration magnitude on tool i, t _i is the lifetime exposure duration for tool i, and m = 0, 1, 2 or 4. Results Among the HTV workers, the initial prevalence and the 1-year incidence of VWF were 18.1 and 1.7%, respectively. At the first examination, the HTV workers with moderate or severe score for VWF showed a significantly increased cold reaction in the fingers when compared with the controls and the HTV workers with no vascular symptoms. At the follow-up, the controls, the asymptomatic HTV workers, and the prevalent cases of VWF did not show significant changes in the cold response of digital arteries. A deterioration of cold-induced digital vasoconstriction was found in the incident cases of VWF. In the HTV workers, vibration doses with high powers of acceleration (i.e., with m > 1) were major predictors of the vasoconstrictor response to cold at the follow-up examination. Conclusions The measurement of FSBP after local cooling may be a helpful objective test to monitor prospectively the change in vibration-induced vascular symptoms. The findings of this longitudinal study suggest a dose–effect relationship between cold-induced digital arterial hyperresponsiveness over time and measures of cumulative vibration exposure. In the controls, the cold response of the digital arteries was stable over 1-year follow-up period. Work presented at the second International Workshop 2006 on Diagnosis of Hand–Arm Vibration Syndrome in G?teborg, Sweden.     

Assessment of autonomic nervous function in patients with vibration syndrome using heart rate variation and plasma cyclic nucleotides

A case-control study was performed to investigate the autonomic nervous function in vibration syndrome. The subjects were 20 patients with a history of Raynaud's phenomenon (vibration white finger (VWF) (+) group), 20 patients without such a history (VWF(-) group), and 20 healthy workers (control group). Their ages and years under medical treatment for vibration syndrome were matched individually among the groups. They were examined using the test of R-R interval variations in the electrocardiogram at rest and during deep breathing and the test of plasma cyclic nucleotide (cyclic AMP and cyclic GMP) responses to whole body exposure to cold. The heart rate variation resulting from respiratory arrhythmia reflects parasympathetic activity; the changes of plasma cyclic AMP and GMP levels reflect sympathetic and parasympathetic receptor functions. The reduced R-R interval variations were observed in the VWF(+) group. Although exposure to cold induced a significant increase of plasma cyclic AMP level, the percentage increase was almost the same among the three groups. The response of plasma cyclic GMP level to cold exposure was highly activated in the VWF(+) and the VWF(-) groups. On the basis of these results, it is considered that the parasympathetic function of patients with vibration syndrome is lower at rest, and that exposure to cold induces a hypperresponse of the parasympathetic nervous system and the alpha-2 adrenergic mechanism as a result of activation of the sympathetic nervous system. Moreover, in patients with VWF, the contribution of the alpha-2 adrenergic mechanism is presumably larger than that in the patients without VWF.     

Assessment of autonomic nervous function in patients with vibration syndrome using heart rate variation and plasma cyclic nucleotides.

A case-control study was performed to investigate the autonomic nervous function in vibration syndrome. The subjects were 20 patients with a history of Raynaud's phenomenon (vibration white finger (VWF) (+) group), 20 patients without such a history (VWF(-) group), and 20 healthy workers (control group). Their ages and years under medical treatment for vibration syndrome were matched individually among the groups. They were examined using the test of R-R interval variations in the electrocardiogram at rest and during deep breathing and the test of plasma cyclic nucleotide (cyclic AMP and cyclic GMP) responses to whole body exposure to cold. The heart rate variation resulting from respiratory arrhythmia reflects parasympathetic activity; the changes of plasma cyclic AMP and GMP levels reflect sympathetic and parasympathetic receptor functions. The reduced R-R interval variations were observed in the VWF(+) group. Although exposure to cold induced a significant increase of plasma cyclic AMP level, the percentage increase was almost the same among the three groups. The response of plasma cyclic GMP level to cold exposure was highly activated in the VWF(+) and the VWF(-) groups. On the basis of these results, it is considered that the parasympathetic function of patients with vibration syndrome is lower at rest, and that exposure to cold induces a hypperresponse of the parasympathetic nervous system and the alpha-2 adrenergic mechanism as a result of activation of the sympathetic nervous system. Moreover, in patients with VWF, the contribution of the alpha-2 adrenergic mechanism is presumably larger than that in the patients without VWF.     

Medial plantar nerve conduction velocities among patients with vibration syndrome due to rock-drill work

OBJECTIVE: The present study was aimed at clarifying the effect of vibration syndrome (VS) on the peripheral nervous system in the lower extremities of patients with VS due to rock-drill work. METHODS: Fifty-three patients with VS due to previous exposure to vibration from rock-drilling work and 55 age-matched controls were examined for sensory nerve conduction velocities in the medial plantar nerve (SCV-P). The patient group was divided into three subgroups, outdoor rock-drill workers with vibration-induced white finger (VWF) (N = 10), tunnel workers with VWF (N = 27) and tunnel workers without VWF (N = 16). RESULTS: ANOVA of SCV-P for the four groups showed F = 3.23 (dF = 3, 104, p = 0.0253). A significant difference was found between the controls and outdoor rock-drill workers with VWF group (p = 0.0261) by multiple comparison using Scheffe's method. CONCLUSION: These findings suggest that peripheral nervous system function in the lower extremities of patient with VS is affected by cold exposure and circulatory disturbance manifested as VWF.     

铅接触工人自律神经系统功能的研究

为了探讨长期低浓度铅接触对自律神经系统功能的影响，对蓄电池厂和工业陶瓷厂铅接触工人进行了自律神经系统功能心电图测试和问卷调查，以公司白领人员为对照组。结果未能显示铅接触与自律神经功能下降有直接关系（Ｐ＞０．０５），反之提示年龄增长是影响自律神经功能的重要因素（Ｐ＜０．０１），问卷调查铅接触组自律神经功能失调症状发生率差异没有显著性（Ｐ＞０．０５）。因此根据本研究结果尚不能认为长期低浓度铅接触对自律神经功能有显著影响。本研究对探讨重金属对自律神经系统的影响进行了有益的尝试。     

Relation of haemostatic function, neurovascular impairment, and vibration exposure in workers with different stages of vibration induced white finger.

Haemostatic function and neurovascular symptoms were investigated in 67 workers exposed to vibration and 46 comparable referents. Of these 65.6% of vibration workers complained of neurological disturbances (stages 0T, 0N of Taylor's classification for vibration induced white finger (VWF) and 20.9% suffered from Raynaud's phenomenon (stages 1-2-3). The severity of the staging symptoms showed a close relation with an index of vibration dose computed on the basis of vibration measurement and individual exposure time. Indices of platelet aggregation, both in vitro and in vivo, antithrombin III, fibrinogen and fibrinopeptide A levels were not different in the exposed workers compared with the referents. No relation was found between haemostatic parameters and the severity of VWF. Exposed workers responded to a cooling procedure with a more pronounced vasoconstriction in the digital vessels than the referents, as indicated by delayed recovery time of finger skin temperature after the cold test. These findings suggest that both in the early stages (0T, 0N) and in more severe stages of VWF (stages 1-2) cold induced hyperreactivity in the digital vessels and Raynaud's syndrome are vascular disorders of functional origin occurring without any prethrombotic alterations.     

Autonomic and peripheral nervous system dysfunction in workers exposed to hand-arm vibration: a study of R-R interval variability and distribution of nerve conduction velocities

Summary To assess the effects of vibrating-tool operation on the autonomic and peripheral nervous system, we measured the variability in the electrocardiographic R-R interval (CV_RR) and the distribution of nerve conduction velocities (DCV) in 24 men who were vibrating-tool operators and in 17 healthy adult men (control group). Of the 24 tool operators, 13 had a history of vibration-induced white finger [VWF(+) group] and 11 had no such history [VWF(–) group]. Two components of CV_RR, i.e. C-CV_RSA and C-CV_MWSA, which have been considered to reflect parasympathetic and sympathetic activities, respectively, were also examined. Both the CV_RR and the C-CV_RSA in the VWF(+) group and the CV_RR in the VWF(–) group were found to be significantly depressed as compared with the control values; moreover, a significant difference in the C-CV_RSA was observed between the VWF(+) group and the VWF(–) group. The faster DCVs and the sensory median nerve conduction velocity were significantly slowed in the VWF (+) and VWF(–) groups. The C-CV_MWSA was significantly correlated with most of the DCV parameters and with the median nerve conduction velocities in all 24 vibrating-tool operators. These data suggest that operation of vibrating tools, which involves exposure to combined stressors of local vibration, heavy work, climate, and noise, affects both the faster myelinated nerve-fiber activity and the parasympathetic activity; the sympathetic activity at rest in workers exposed to hand-arm vibration may be related to depression of peripheral nerve conduction.