镉污染区居民肾功能状况调查

镉污染区居民肾功能状况调查中国医科大学预防医学系（沈阳１１０００１）徐兆发，卢素英，李革新，陈爱丽辽宁省卫生防疫站袁一傲，崔仲明环境镉污染对居民健康的影响，受到越来越多的关注．为此，本文对沈阳郊区长期生活在镉污染区的居民进行了体内镉负荷和肾功能状况的...     

镉污染区居民肾功能损害的研究

目的探讨镉污染停止20余年后镉对接触人群的肾功能损害情况.方法于2001年,分别选择在张士灌区重、中、轻污染区及非污染区居住20 a以上的39、65、57及42名居民为调查对象,测定其尿镉(UCd)、尿N-乙酰-β-D-氨基葡萄糖苷酶(UNAG)、尿β2-微球蛋白(UBMG)、尿视黄醇结合蛋白(URBP)及尿白蛋白(UALB)水平,这些指标的水平均用尿肌酐校正,并用几何均数进行比较.结果与1992年相比,轻、中、重污染区及非污染区居民尿镉水平明显下降,但重、中、轻污染区居民的UCd、UNAG、UBMG、URBP水平及UNAG的异常率均高于非污染区居民(均P＜0.01);UNAG、UBMG、URBP、UALB水平和异常率均随尿镉水平的升高而增加,尤以尿镉水平达10μg/g Cr以上明显高于5μg/g Cr以下组.尿镉及肾损伤指标间均存在正相关(均P＜0.01).结论镉引起肾小管的不可逆损伤,严重者累及肾小球;尿镉水平可反映体内镉负荷及肾功能损害程度.     

福州市市售食物铅砷镉污染状况分析

目的 检测福州市主要10类食物中铅、镉、砷含量，了解食物中重金属铅砷镉污染水平。方法 按食品卫生理化检验方法GB／T5009—96标准方法检测。结果 检测10类320份食品，达到国家食品卫生标准为262份，合格率为81．9％。结论 重金属铅砷镉通过食物摄人人体从而造成健康危害，污染主要来源与工业三废排放，农药的使用和食品加工中的二次污染有关。     

2004-2010年北京市顺义区猪肾中镉污染水平监测

目的调查北京市顺义区猪。肾中镉污染状况及变化趋势。方法从2004-2010年在全区范围内连续7年开展重金属镉在猪肾中污染水平的监测工作。结果7年获得监测数据134个,结果表明镉在猪内脏中蓄积水平显著高于其他肉品,且镉在猪肾中污染水平显著高于肝脏,从2006年后顺义区猪肾中镉污染上升趋势显著,自2008年污染水平明显下降。结论我区现阶段猪肾中镉污染并不严重,但对猪肾摄人量高的人群容易造成健康危害,应继续加大对猪肾中镉的监测力度,密切监视变化趋势。     

北京市海淀区猪肾中铅砷镉污染状况

目的了解海淀区猪肾中重金属铅砷镉的污染情况。方法按照《北京市食品污染物监测体系项目工作方案》要求,在全区范围内采集30份样品,参照GB/T5009-2003方法进行测定。结果30份样品中,砷检测结果均低于国家食品卫生限量标准,最大值0.45mg/kg;铅检测结果有3份超标,超标率10.0%,最大值0.68mg/kg;镉检测结果有29份超标,超标率达96.7%,最高的超标34倍。结论该区销售的猪肾中受铅、砷污染情况并不严重,而受镉污染的情况比较严重。应加大畜禽肝、肾脏部位重金属的监测和力度,指导市民科学饮食。     

广西5城市农产品铅镉污染分析

目的了解广西壮族自治区5城市主要农产品铅镉污染情况。方法在严格的质量控制下，对5个城市8类农产品进行铅镉污染监测。结果共监测8类588件农产品，获得923个有效监测数据。其中铅污染监测429件农产品，3个市的皮蛋污染严重，铅超标率均在50％～75％；南宁市蔬菜、黄豆铅污染超标均在30％以上；百色市牛奶超标率达到100％；而镉污染监测494件农产品，北海市螺、蟹镉污染超标率分别达到93．0％，82．0％；3个市肾镉超标均在80％以上；南宁、玉林市大米镉超标率均为28．6％，南宁市蔬菜超标率24．3％；南宁市大白菜、白萝卜、胡萝卜、四季豆等共9份农产品铅、镉同时超标，双重超标率达到15．2％（9／59）。结论农产品中存在铅镉污染，应加强综合治理。减少环境污染。     

非镉污染区居民中尿白蛋白水平状况的调查

长期慢性镉中毒可以使肾小球受到损害,导致尿白蛋白含量的增加。由于不同年龄健康人尿中白蛋白的含量不同,所以为了更准确地评价镉对肾脏损害的程度,有必要对不同年龄健康人尿中白蛋白进行调查,摸清其水平状况及分布规律。1 方法 随机选择在当地居住30年以上的居民253名,年龄从35～84岁。样品采集为即时尿,然后冷藏。尿白蛋白浓度按尿微蛋白酶免疫测定试剂盒进行分析。尿肌酐(Cr)采用饱和苦味酸法测定。用EPI(第5版)软件进行数据统计。     

吉林省9市农产品铅镉污染监测分析

随着工业化水平迅速发展,环境问题日益严峻,对农产品的污染不容忽视。为了掌握吉林省农产品重金属铅、镉的污染情况及其分布,笔者于2008年对吉林省9个市的部分农产品进行了铅镉污染情况豁测。     

贵州省赫章县镉污染区人群健康损害状况调查及损害指标关系探讨

目的了解贵州省赫章县环境镉污染区人群健康状况。方法通过随机抽样方法获得调查对象,采集人群尿样,等离子发射光谱-质谱法(ICP-MS)检测尿镉,分光光度法测定N-乙酰-β-D-氨基葡萄糖苷酶(NAG)和肌酐,放射免疫法测定β2-微球蛋白等指标。结果完成人群尿样筛查共1351人份,污染区948人,对照区403人。污染区与对照区人群尿镉水平分别为8.79和2.93μg/g Cr,差异有统计学意义(P<0.05),尿镉阳性率分别为10.8%和1.2%。两地区人群尿β2-MG和尿NAG水平差异无统计学意义。污染区与对照区人群联合反应率分别为1.6%和0.5%。结论赫章县环境镉污染对人群存在潜在健康危害,联合检测尿镉、NAG和β2-微球蛋白能够全面反映环境镉污染的健康危害。     

郑州地区蔬菜中镉污染状况调查与分析

采用石墨炉—原子吸收分光光度法对郑州地区20个蔬菜品种268个样品的可食用部分中重金属元素镉的含量进行了监测,分析了各类蔬菜中镉的含量及其分布特征。结果表明:在监测的20个蔬菜品种中,叶菜类镉超标率最高(7.8%),白菜类次之(3.0%),其他菜类未见超标现象。超标样品主要分布在上街、巩义等工业化水平较高的区县,且超标样品采集地点分布较为集中。郑州地区蔬菜存在镉污染的情况,但范围有限,主要集中在有工业污染的地区。     

Renal response to cadmium in a population living in a nonferrous smelter area in Belgium

Summary The exposure to cadmium and the kidney function of 60 women (more than 60 years old) who have lived in a cadmium-polluted area in Belgium have been compared with those of 70 women of the same age who have lived in another industrial area not polluted by cadmium. None of the subjects had been occupationally exposed to heavy metals.The group of women from the cadmium-polluted area (Liège) had a higher cadmium body burden as reflected by an increased excretion of cadmium in urine and a higher prevalence of signs of renal dysfunction than the women from the control area.     

沈阳张士灌区镉的环境污染与人群健康影响的研究

张士灌区利用含镉工业废水灌溉农田已有35年的历史,灌区环境受到了严重污染,糙米中的镉含量;重污染区高达1.0mg/kg以上;中污染区0.5mg/kg左右;轻污染区为0.2mg/kg;猪体内脏器中的含镉量是对照区的7～9倍。据计算,重、中污染区居民每日平均摄入的镉量己超过日本规定限量标准(300μg)的1～2倍。对污灌区188名30岁以上的妇女健康检查结果,发现有腰、背、四肢疼痛者占71％,其中有关节活动受限制者6.1％。尿镉在10μg/g肌酐以上,同时尿低分子蛋白、β_z-MG,氨基氮,尿钙和血清碱性磷酸酶含量升高,表明有肾小管损伤、骨质疏松或软化。按我国“职业性慢性镉中毒诊断标准”衡量,目前张士灌区的重、中污染区约有10％的受检人群达此标准、对此,作者提出了积极防治意见。     

镉中毒时肾细胞内微量元素含量的改变

目的了解微量元素在镉中毒性肾损伤中的作用及机制。方法制备镉中毒性肾损伤的动物模型，测定了肾细胞亚细胞成分中微量元素的含量、脂质过氧化反应及肾功能、超微结构的改变。结果镉的摄入使主要分布于线粒体的铜、锌、锰向胞核和胞浆转移，而线粒体、胞液中硒含量与谷胱甘肽过氧化物酶活性均降低，丙二醛则升高。结论提示镉性肾损伤时微量元素尤其是硒的改变可能与脂质过氧化反应增强有关，细胞内微量元素分布异常也可能是影响镉性肾损伤的重要因素之一。     

The effects of environmental cadmium exposure on kidney function: the possible influence of age

The study aimed to assess the possible influence of long-term environmental exposure to cadmium and age at the time of exposure on renal function. The study was a follow-up of the 1991-1994 project concerning 2000 inhabitants of a cadmium-contaminated area in the vicinity of a zinc smelter. Since the smelter was built in the late 1950s but was not operated until 1968, some of the inhabitants were not exposed to cadmium during childhood. For the follow-up, 308 persons who in 1993 presented with Cd-U levels > or = 0.5 microg/L adjusted for specific gravity (1.020) were selected in 2000. The study population included 136 people who were exposed to cadmium in childhood (former children) and 172 adults (unexposed adults) with no such exposure. These two groups were divided into subgroups according to Cd-U levels: < or =1 (group 1), 1-2 (group 2), and > or =2 microg/g creatinine (group 3). Urinary and blood cadmium and the markers of renal tubular dysfunction (beta2 M-U, RBP-U, NAG, NAG-A, NAG-B) and glomerular dysfunction (Alb-U and beta2 M-S) were measured. Persons with a history of occupational exposure to cadmium were excluded from this project. In group 3 of the unexposed adults, concentrations of RPB-U, NAG, NAG-B, and Alb-U were significantly higher than those in group 1. In former children, this could be observed only for RPB-U and Alb-U. Urine concentrations of these markers were higher in all of the subgroups of former children than in the groups of unexposed adults (except for NAG and its two forms). However, these differences were significant only for RBP-U in group 3. The findings indicate that early renal effects in the general population may occur at Cd-U concentrations above 2 microg/g creatinine and at lower levels for NAG-B. Moreover, cadmium exposure in childhood may have a stronger impact the renal function, particularly tubular reabsorption, than the exposure of a mature organism.     

The effects of low environmental cadmium exposure on bone density

Recent epidemiological data indicate that low environmental exposure to cadmium, as shown by cadmium body burden (Cd-U), is associated with renal dysfunction as well as an increased risk of cadmium-induced bone disorders. The present study was designed to assess the effects of low environmental cadmium exposure, at the level sufficient to induce kidney damage, on bone metabolism and mineral density (BMD). The project was conducted in the area contaminated with cadmium, nearby a zinc smelter located in the region of Poland where heavy industry prevails. The study population comprised 170 women (mean age=39.7; 18-70 years) and 100 men (mean age=31.9; 18-76 years). Urinary and blood cadmium and the markers of renal tubular dysfunction (β₂M-U RBP, NAG), glomerular dysfunction (Alb-U and β₂M-S) and bone metabolism markers (BAP-S, CTX-S) as well as forearm BMD, were measured. The results of this study based on simple dose-effect analysis showed the relationship between increasing cadmium concentrations and an increased excretion of renal dysfunction markers and decreasing bone density. However, the results of the multivariate analysis did not indicate the association between exposure to cadmium and decrease in bone density. They showed that the most important factors that have impact on bone density are body weight and age in the female subjects and body weight and calcium excretion in males. Our investigation revealed that the excretion of low molecular weight proteins occurred at a lower level of cadmium exposure than the possible loss of bone mass. It seems that renal tubular markers are the most sensitive and significant indicators of early health effects of cadmium intoxication in the general population. The correlation of urinary cadmium concentration with markers of kidney dysfunction was observed in the absence of significant correlations with bone effects. Our findings did not indicate any effects of environmental cadmium exposure on bone density.     

污灌土壤有机提取物对小鼠肝肾功能的影响

目的研究土壤有机提取物对小鼠肝、肾功能的影响。方法于2007年5月,选取某污灌农田土壤为研究对象,地下水灌溉农田土壤为对照,采用超声振荡法提取土壤中的有机污染物。将40只健康清洁级昆明种小鼠随机分为5组,分别为溶剂对照组(二甲亚砜)、对照区低剂量组、对照区高剂量组、污灌区低剂量组、污灌区高剂量组,雌雄各半。高、低剂量组染毒剂量(以土壤干重计)分别为25、5g/(kg·d)。采用灌胃方式进行染毒,每日1次,灌胃容量为5ml/kg,连续染毒2周。于第15天处死动物、称重,称量肝、肾组织重量,计算肝、肾组织的脏器系数。测定谷草转氨酶(AST)、谷丙转氨酶(ALT)、γ谷氨酰转肽酶(GGT)活力和尿酸(UA)、肌酐(Cr)、尿素氮(UN)含量。结果各组小鼠体重变化差异无统计学意义(P>0.05)。与溶剂对照组比较,对照区和污灌区各剂量组的肝脏和肾脏重量及其脏器系数均降低,污灌区低剂量组肝组织中的GGT活力和肾组织中的UN含量以及污灌区高剂量组肝组织中的ALT、GGT活力和肾组织中的Cr、UN含量均升高,差异有统计学意义(P<0.05或P<0.01)。与对照区相同剂量组比较,污灌区高剂量组肝组织中的GGT活力和肾组织中...     

应用铈细胞化学方法观察镉诱发氧自由基对肾脏的损伤

目的研究镉及其诱发的氧自由基对肾脏的急性损伤。方法应用电镜细胞化学及能量色散谱分析技术。结果镉离子可进入到肾近曲小管上皮细胞内。肾组织内有氧自由基的过量产生,其主要位于血管内皮细胞,肾近曲小管上皮细胞的线粒体,微绒毛及基底膜等部位。肾近曲小管上皮细胞及线粒体可发生肿胀及内皮细胞脱落等病变。结论镉离子可导致氧自由基的大量形成,从而对肾脏造成损伤。     

女性脑卒中危险因素配对病例对照研究

本文对128对女性脑卒中病人进行了配对病例对照研究。经条件Logistic回归分析,结果表明高血压、冠心病明显与女性脑卒中有关,OR值分别为6.09和1.84;血压水平也与发病明显有关,收缩压升高的OR值为2.55,舒张压升高的OR值为4.25,双期血压均升高的OR值是4.67;吸烟与女性脑卒中有关(OR=1.85,P<0.05);生殖周期越长越不易得病(OR=0.92,P<0.001)。同时对其它有关因素也进行了分析。     

小剂量氯化汞对小鼠的生殖毒性

目的观察小剂量氯化汞对雄性小鼠生殖功能的毒性作用以及氯化汞对小鼠精子数量和质量的影响。方法雄性ICR小鼠随机分为4组:阴性对照组,0.25、0.50、1.00mg/kg氯化汞组。分别以0.25、0.50、1.00mg/kg氯化汞腹腔染毒4周龄雄性小鼠每3天1次,共10次。50d后以雌雄2∶1合笼交配,观察雌鼠受孕率、生育子胎数、胎鼠重量,同时测定睾丸指数、附睾精子数量、精子活动率和精子畸形率。结果对照组、0.25、0.50和1.00mg/kg组合笼1周雌鼠受孕率分别为100%、100%、83.33%和66.67%,合笼3周雌鼠受孕率分别为100%、100%、83.33%和75%;其中1.00mg/kg组1周雌鼠受孕率显著低于对照组(P<0.05)。以上各组母鼠生育子胎数分别为127、142、113、95只,异常妊娠率分别为0%、1.41%、2.65%和4.21%;1.00mg/kg组异常妊娠率显著高于对照组(P<0.05)。0.50、1.00mg/kg组附睾精子数显著低于对照组和0.25mg/kg组(P<0.05);0.25、0.50、1.00mg/kg组睾丸指数、精子活动率与对照组比较差异无显著性(P>0.05)附睾精子畸形率显著高于对照组(P<0.05)。结论1.00mg/kg氯化汞染毒可降低雄性小鼠生育力,增加了受孕雌鼠异常妊娠率。氯化汞引起的这种雄性小鼠生育力的降低、异常妊娠率的增高可能与精子畸形率增高和精子数量下降有关。