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。

Relationships between the Peripheral Circulating Functions of Hands and the Vascular Endothelial Active Substances in Coal Mine Drillers

Objective ] To research the effects of hand-arm vibration on the peripheral circulating functions of hands and the relationships between the cool water loading test and the vascular endothelial active substances in coal mine drillers. Methods ] Sixty-four coal mine drillers were divided into high-exposure group, middle-exposure group and low-exposure group by the their accumulative ddrations of exposure to hand-arm vibration. The vascular endothelial active substances were measured and cool water loading tests（ CWLT ） were carried out in each group, and then relationships between vascular endothelial active substances and the test results were analyzed. Results ] Compared with control group, the serum concentrations of endothelin （ ET ） and thromboxane B2（ TXB2 ）increased significantly and the serum concentrations of nitric oxide（ NO ）and 6-keto- prostaglandin Fla （6-keto-PGFla） decreased significantly （P 〈 0.01 ）. Compared with control group, the skin temperatures in high-exposure group before CWLT and the skin temperatures at the time points of 5 rain, 10 min and 30 min after CWLT in all the exposure groups decreased significantly（ P 〈 0.01 ）. There existed significant positive relationships between 10 min temperature recovery rates and 30 min temperature recovery after CWLT and vibration exposure doses （ P 〈 0.01 ）. There existed obvious positive relationships between temperature recovery rates and ET concentrations and TXB2 concentrations, and obvious negative relationships between temperature recovery rates and NO concentrations and 6-keto-PGF1α concentrations （ P 〈 0.01 ）. Conclusion ] There is a consistence between disorders of vascular endothelial substances and temperature recovery of the hand skin in hand-ann vibration workers, hence the disorders of vascular endothelial substances induced by hand-arm vibration could be used as an index in the evaluation of vibration-induced vascular impairment.