职业性铅接触尿N-乙酰-β-D-氨基葡萄糖苷酶活性的变化

目的研究铅接触者尿N-乙酰-β-D.氨基葡萄糖苷酶(NAG)活性变化。方法对某蓄电池厂135名铅作业工人及52名非接触者进行了尿铅含量及尿NAG活性测定。结果接触组工人尿NAG[(13.91±1.62)U/gCr]活性明显高于对照组[(7.82±1.55)U/gCr]。随着尿铅水平升高,尿NAG活性有升高趋势。接铅1～3年组尿NAG活性开始上升,7年以上明显增加。结论尿NAG活性似可作为铅致肾损害的早期生物标志物。     

稀土作业工人尿中N—乙酰—β—D氨基葡萄糖苷酶活性的初步研究

尿中N-乙酰-β-D氨基葡萄糖苷酶(NAG)活性能反映肾实质进行性和破坏性损害,是一项检测肾实质受损的敏感指标。为了解稀土粉尘对作业工人肾脏是否有不良影响,对接触稀土粉尘的部分男性工人尿中NAG活性进行了测定。结果表明,不接触稀土粉尘者尿中NAG活性为19.9±2.5U/gCr,接触者为17.5±3.1～87.1±2.1U/gCr,以原料工和纯稀土冶炼工为高,与非接触组之间有显著性差异。但对接触稀土粉尘者尿中NAG活性升高是否由稀土所致,还需要对接触者肾功能进行全面检测研究。     

职业接触汞工人肾脏早期损伤指标的探讨

目的　探讨职业接触汞工人肾损伤的早期监控指标。方法　尿汞 (HgU)采用二硫腙化学法测定 ,尿视黄醇结合蛋白 (RBP)、尿 β2 微球蛋白 (β2 MG)和尿微量白蛋白 (mALB)采用全定量酶免疫法测定 ,尿N 乙酰 β D 氨基葡萄糖苷酶 (NAG)和γ 谷氨酰基转移酶 (γ GT)采用速率法测定 ,尿肌酐(Cr)采用苦味酸法测定。结果　职业接触汞工人尿RBP、β2 MG、NAG、γ GT测定结果分别为 (4 39.7±2 0 1.4 )、(14 1.4± 5 6 .3) μg gCr,(12 .3± 5 .7)、(6 0 .3± 18.5 )U gCr,均高于对照组 [分别为 (2 4 3.2±16 9.1)、(88.6± 4 1.2 ) μg gCr,(8.2± 1.6 )、(4 1.3± 13.2 )U gCr],差异均有显著性 (P <0 .0 5 ,P <0 .0 1)。随尿汞含量增加上述指标有逐渐增高的趋势 ;单项及两项检测RBP、β2 MG、NAG、γ GT的阳性率较低 ,联合其中 3项检测阳性率较高 ,联合 4项检测阳性率可达 85 .5 %。结论　联合检测RBP、β2 MG、NAG、γ GT是诊断职业接触汞工人早期肾损伤的灵敏指标。     

铅作业工人肾损害早期指标研究

目的：探讨铅作业工人肾脏损害的早期指标及其临床意义。方法：80名铅作业工人分为铅接触正常组、铅吸收组、慢性轻度铅中毒组,并以无铅接触史的43名健康成人作为对照组。分别测定血铅(PbB)、尿铅(PbU)、血红细胞游离原叶啉(FEP)、尿δ—氨基酮戊酸(δ-ALA)、尿β2-微球蛋白(β2-MG)、尿N-乙酰-β-D氨基葡萄糖苷酶(NAG)、尿视黄醇结合蛋白(RBP)。结果 铅作业工人PbB、PbU、H0、δ-ALA、NAG、RBP均显著高于对照组;β2-MG虽亦高于对照组,但差别无显著性。结论:长期职业性铅接触可造成肾功能损害,尿NAG、RBP可作为铅中毒肾损害早期敏感的监测指标。     

铅作业人员血铅及肾功能结果比较

目的探讨铅致肾损伤生化指标的变化。方法选择某蓄电池厂60名铅作业工人（接触组）和33名某机关人员（对照组）的血铅含量、尿总蛋白（UTP）、尿β2-微球蛋白（β2-MG）、血清肌酐清除率等指标进行比较分析。结果接触组血铅（0.304±0.05）mg/L、尿UTP（56.78±8.96）mg/gCr、尿β2-MG（98.64±2.06）μg/gCr等指标显著高于对照组（P〈0.05）。结论β2-MG是肾功能早期损害敏感指标之一,将其作为铅接触人群健康监护指标具有实际意义。     

职业性接触铅引起血铅变化和肾损害及其关系的研究

目的 研究职业性铅接触的肾脏毒性,探讨血铅浓度变化和肾脏损害指标之间的关系.方法 车间空气中铅烟、铅尘的短时间接触浓度用石墨炉原子吸收法检测.选择一般情况可比的无铅接触史的石棉厂个人作为对照,根据接触铅的浓度是否超过职业限值将233名铅接触工人分为职业限值内组及超职业限值组.选择尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)和β2-微球蛋白(β2-MG)作为肾脏损伤的效应指标,分析不同血铅水平肾损伤效应指标的变化.结果 ①车间空气中铅烟、铅尘的短时间接触浓度分别迭0.15 mg/m3和0.14 ms/m3,超标率分别为71.67%和44.51%;②接铅超职业限值组血铅浓度达(3.46±0.07)μmol/L、尿NAG为(1.82±0.12)U/mmolCr,均显著高于对照组(P＜0.01);③血铅浓度的变化和尿NAG、β2-MG的异常率存在一致的变化趋势,趋势χ2分别为96.27和7.18(P＜0.01);④Logistic回归分析发现接铅水平引起尿NAG和β2-MG改变的OR(95%CI)分别为2.77(1.70～4.52)和1.68(1.08～3.17).结论 职业性铅接触引起血铅浓度升高和肾脏损伤,且血铅浓度越高,肾脏损伤的程度越大.     

职业性铅接触与尿γ-谷氨酰转肽酶活性关系的研究

目的　探讨铅接触者尿γ 谷氨酰转肽酶 (γ GT)活性变化及其意义。方法　对两个蓄电池厂共112名铅作业工人进行血铅及尿γ GT活性测定。 71名非铅接触者为对照。血铅含量用微分电位溶出法进行测定 ;γ GT活性用对氨基苯磺酸比色法进行测定。结果　铅接触者尿γ GT活性升高 ,与对照组比较差异有显著性 (P <0 0 5 ) ;随着血铅水平的升高 ,尿γ GT活性有升高趋势 ;小于 1年工龄组及大于 5年工龄组尿γ GT活性明显高于对照组 (P <0 0 5 ) ;而 1～ 5年工龄组尿γ GT活性与对照组相比差异无显著意义(P >0 0 5 )。结论　尿γ GT活性升高是反映铅中毒的敏感指标 ,其变化可反映铅接触者肾损害的程度     

慢性铅接触早期肾损害指标的分析

目的研究慢性铅接触者的早期肾损害指标。方法①对83例血铅增高的慢性铅接触工人按工龄分组,并测定尿N-乙酰-B-D-氨基葡萄糖苷酶(NAG)、尿β2-微球蛋白(β2-MG)、尿溶菌酶(Lys)、血尿酸(UA)、内生肌酐清除率(Ccr)等指标;②按是否单纯NAG增高分组,说明NAG在其中的意义。结果①慢性铅接触者NAG、β2-MG明显增高[分别为(18.2±3.7)vs(8.9±2.2),(0.48±0.12)vs(0.36±0.06),P<0.01,P<0.05],UA、Lys、Ccr无明显差异;②铅接触工龄1年以上者,NAG即有明显增高(18.2±3.3)vs(8.9±2.2),P<0.01);③单纯NAG增高组血铅水平明显低于非单纯NAG增高组[(2.292±0.437)vs(2.524±0.493),P<0.05]。结论铅的肾损害早期位于肾小管,尿NAG是最敏感的指标。     

慢性铅接触者肾损害早期监测指标的研究

[目的]估算引起肾功能损害的血铅的基准剂量(BMD)和基准剂量可信区间下限(LBMD)，探索铅接触引起肾损害的生物接触限值。[方法]选择某蓄电池厂的工人135名为铅接触组，以机械工人和学生为对照。观察了血铅含量与尿总蛋白(TP)、尿β2-微球蛋白(β2-MG)和尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)的关系。用BMDS Version1．3．1软件的logistic模型进行基准剂量估算。[结果]引起肾损害的血铅BMD和LBMD分别为299．4～588．7μg／L和253．4～402．3μg／L，引起肾损害血铅LBMD大小依次为TP、β2-MG和NAG。[结论]尿NAG是监测肾功能损害最敏感的指标，进行铅接触人群肾功能评价时血铅水平达到250～400／μg/L要引起重视。     

驱铅对尿β2-MG、NAG、RBP的影响

通过接铅组与对照组及接铅者不同连续驱铅时间分组的PbB,ZPP,尿β2-MG、NAG、RBP检测结果比较,及其各指标在不同驱铅时间的下降程度与恢复至对照组水平的人数分析,表明尿β2-MG、NAG、RBP 3指标在连续驱铅过程中的变化明显,并且不受接铅影响。 更多还原     

铅接触人群β2-MG、NAG、RBP值的变化观察

目的 研究接铅工人β2 - MG、NAG、RBP的变化.方法 采用分组比较与各指标增高人数分布描述法.结果 接铅组β2 - MG、NAG、RBP比对照组增高2倍以上.按接铅工龄分组分析,有随着接铅工龄延长而增高的趋势;分组比较,除了ZPP仅在1～2年组与5～6年组间有明显差别之外,其他指标在1～2年组与3～4、5～6年组间均有明显差别;但各指标在3～4年组与5～6年组间均无明显差别.按pbB值分组分析,有随着血铅值增高而增高的趋势;分组比较,除了NAG在各组间无差别之外,其他指标在＜400组与400 ～ 600组、＞600组间均有明显差别;在400 ～ 600组与＞ 600组间比较,除了ZPP之外,其他指标在两组间均有明显差别.分析接铅组β2 - MG、NAG、RBP的增高人数,各以56.59、72.35、57.23％分布于3倍对照均值组.结论 β2 - MG、NAG、RBP值的变化与接铅工龄和血铅值有一定关系,并且3指标增高人数的集中分布趋势较pbB、ZPP明显.     

尿生化指标检测在肾功能早期改变中的诊断价值

目的探讨尿生化指标检测在肾功能早期改变中的诊断价值。方法将青龙县人民医院2010年8月-2011年3月收治的100例肾病患者为研究对象,按照肾小球滤过率（GFR）的大小,将其分为肾功能正常组38例（A组）,肾功能损害组62例（B组）,另选取健康体检者40例作为对照组,测定肾病组患者治疗前后及对照组的尿胱抑素C（Cy-sC）、尿N-乙酰-D-D氨基葡萄糖苷酶（NAG）、尿β2-微球蛋白（β2-MG）、尿比重（SG）。结果肾病组的尿CysC、NAG、β2-MG显著高于对照组（P〈0.05）,尿SG显著低于对照组（P〈0.05）;B组的尿CysC、NAG、2β-MG显著高于A组（P〈0.05）,尿SG显著低于A组（P〈0.05）;肾病组经治疗后尿CysC、NAG、β2-MG较治疗前显著降低,尿SG较治疗前显著升高（P〈0.05）。结论尿生化指标可作为肾功能损害较好的检测诊断指标,在一定程度上可反映病情的严重程度,且操作简便,值得临床推广。     

铅作业工人尿N-乙酰-β-D-氨基葡糖苷酶同工酶活性的研究

本文对227名铅作业工人的肾功能和卟啉代谢状况进行了研究。结果表明卟啉代谢紊乱先于铅中毒性肾损害,铅接触组的尿NAG-A活性显著低于对照组,而尿NAG-B无明显变化;尿NAG-A活性下降是反映铅中毒性肾损害较敏感的指标,其检测价值比尿总NAG测定大。尿NAG-A活性检测可作为铝中毒性肾损害的监测指标。     

A nine year follow up study of renal effects in workers exposed to cadmium in a zinc ore refinery.

Renal changes with time have been studied in 14 workers engaged in the production of cadmium (Cd) in a zinc ore refinery. These workers were examined once a year in the period 1980 to 1985 and 13 of them also in 1989. Four of the workers (group A) had been employed in an old Cd plant before 1973 and had received higher exposures to Cd than the other workers (group B). Average urinary Cd concentrations over the whole study period in workers of group A ranged from 6.9 to 9.2 micrograms/g creatinine (median 8.4 micrograms/g) and in workers of group B from 0.64 to 7.1 micrograms/g creatinine (median 1.9 micrograms/g). Renal effects were assessed by the determination of urinary N-acetyl-beta-D-glucosaminidase (NAG), beta 2-microglobulin (beta 2-M), retinol binding protein, albumin, total protein, and serum creatinine concentrations and activity. Urinary beta 2-M concentrations in three of four workers of group A were close to or marginally above the upper normal limit during the study period. The beta 2-microglobinuria was not, however, progressive. No values outside normal limits were detected for any of the other renal tests in workers of groups A and B, related to exposure to Cd. Dose-response relations showed that urinary Cd correlated significantly with urinary NAG activity and total protein and beta 2-M. The earliest change induced by Cd was seen for urinary NAG activity within normal limits of NAG excretion. The regression lines were similar in the surveys between 1981 and 1989, indicative of no progression to higher values for any of the renal tests. The current biological exposure index (BEI) of 10 micrograms/g creatinine for workers exposed to Cd, set by the American Conference of Governmental Industrial Hygienists (ACGIH), therefore seems justified, although the safety margin is small. The World Health Organisation recommended limit and ACGIH (1992-3) proposed limit of 5 micrograms/g creatinine would provide a much larger safety margin, and could be regarded as an action point for increased health surveillance.     

对苯二甲酸和乙二醇及联苯-联苯醚对职业人群肝肾损伤的研究

目的　研究对苯二甲酸 (TPA)、乙二醇 (EG)、联苯 -联苯醚 (DOW )对职业人群肝肾损伤的影响 ,寻找作业工人健康监护的早期指标。方法　采用职业流行病学的方法 ,在对某化纤公司进行劳动卫生学调查的基础上 ,分析TPA、EG、DOW接触工人肝肾功能的变化。结果　TPA +EG +DOW接触组男工的血清γ 谷氨酰转肽酶 (GGT)活力和总胆汁酸 (TBA)的含量分别为 (35 .45±16 .0 9)U/L、(10 .2 9± 6 .76 ) μmol/L ,女工的血清丙氨酸转氨酶 (ALT)活力和TBA含量分别为(30 .6 8± 8.5 8)U/L、(9.5 3± 6 .6 3) μmol/L ,均不同程度地高于对照组、TPA接触组和DOW接触组 ,且差异有显著性 (P <0 .0 5、P <0 .0 1) ;TPA +EG +DOW接触组尿N 乙酰 β D 氨基葡萄糖苷酶 (NAG)活力和 β2 微球蛋白 (β2 MG)含量与对照组、TPA接触组和DOW接触组相比 ,差异有显著性 (P <0 .0 5、P<0 .0 1) ,男工为 (5 .6 8± 4.0 1)U/mmolCr与 (2 3.49± 13.44 )mg/molCr;女工为 (6 .6 8± 4.6 8)U/mmolCr与 (2 2 .80± 13.0 0 )mg/molCr。经多元回归分析 ,控制了性别、吸烟、饮酒等混杂因素 ,接触不同的毒物与作业工人肝肾损伤的关系有显著性 (P <0 .0 0 1)。结论　TPA、EG、DOW对职业人群的肝肾损伤存在联合作用 ,建议血清ALT、GGT、TBA、尿NAG和     

Renal tubular function of workers exposed to low levels of cadmium.

Cadmium induced renal tubular effects were examined in 65 female workers in a factory manufacturing nickel cadmium batteries. Urinary beta 2-microglobulin (beta 2m), urinary N-acetyl-D-glucosaminidase activity (NAG), and serum creatinine and serum urea concentrations were used to assess the renal effects. Of the four measures, only urinary NAG and urinary beta 2m showed a strong positive correlation with blood cadmium concentrations (r = 0.49 and 0.43 respectively); NAG showed a weaker correlation with urinary cadmium concentrations (r = 0.35). Urinary beta 2m has weak correlation with urinary cadmium (r = 0.04). Only urinary NAG showed a significant deterioration in renal function among the exposed group. NAG detects the largest proportion of abnormalities among the exposed group. Abnormal urinary beta 2m is detected in only 15.4% of the workers, half of whom have blood cadmium above 10 micrograms/l. The proportion of abnormalities detected by urinary NAG differs significantly from the proportion of abnormalities detected by urinary beta 2m (p less than 0.01). The age adjusted mean urinary NAG excretion showed a significant rise with urinary cadmium of above 3 micrograms/g creatinine. Urinary beta 2m failed to show any significant rise. With blood cadmium concentrations, the age adjusted mean urinary NAG excretion showed a rise from 1 microgram/l of blood cadmium followed by a plateau between blood cadmium concentrations of 3-10 micrograms/l. No significant rise in mean urinary excretion in beta 2m was seen until blood cadmium concentrations exceeded 10 micrograms/l.     

Renal tubular function of workers exposed to low levels of cadmium

Cadmium induced renal tubular effects were examined in 65 female workers in a factory manufacturing nickel cadmium batteries. Urinary beta 2-microglobulin (beta 2m), urinary N-acetyl-D-glucosaminidase activity (NAG), and serum creatinine and serum urea concentrations were used to assess the renal effects. Of the four measures, only urinary NAG and urinary beta 2m showed a strong positive correlation with blood cadmium concentrations (r = 0.49 and 0.43 respectively); NAG showed a weaker correlation with urinary cadmium concentrations (r = 0.35). Urinary beta 2m has weak correlation with urinary cadmium (r = 0.04). Only urinary NAG showed a significant deterioration in renal function among the exposed group. NAG detects the largest proportion of abnormalities among the exposed group. Abnormal urinary beta 2m is detected in only 15.4% of the workers, half of whom have blood cadmium above 10 micrograms/l. The proportion of abnormalities detected by urinary NAG differs significantly from the proportion of abnormalities detected by urinary beta 2m (p less than 0.01). The age adjusted mean urinary NAG excretion showed a significant rise with urinary cadmium of above 3 micrograms/g creatinine. Urinary beta 2m failed to show any significant rise. With blood cadmium concentrations, the age adjusted mean urinary NAG excretion showed a rise from 1 microgram/l of blood cadmium followed by a plateau between blood cadmium concentrations of 3-10 micrograms/l. No significant rise in mean urinary excretion in beta 2m was seen until blood cadmium concentrations exceeded 10 micrograms/l.     

Lead exposure and urinary N-acetyl beta D glucosaminidase activity in adolescent workers in auto repair workshops.

PURPOSE: To investigate levels of lead (Pb) exposure and renal tubular damage among adolescent workers in auto repair workshops in Turkey. METHODS: The study was conducted on 39 adolescent workers (mean age: 16.18 +/- 3.19 years) in auto repair workshops (8 autoelectrician, 10 motor repairman, 8 auto painter, 5 turner, 8 bonnet straighter). Thirteen adult employees of battery production in the workshops (mean age: 32.08 +/- 10.94 years) and 29 healthy rural adolescent (mean age: 14.78 +/- 2.68 years) constituted the control groups. The level of blood Pb was investigated by an atomic absorption spectrophotometer and urinary N-acetyl beta- D glucosaminidase (NAG) activity was measured by a colorimetric method. Mann-Whitney U test was performed to examine group differences. RESULTS: All subjects and controls had normal blood urea, creatinine, uric acid, sodium, potassium levels, normal routine urine examination and tubular phosphorus reabsorption. Blood Pb levels in auto repair workers (8.13 +/- 7.41 mug/dL) were significantly higher than the rural control group (3.49 +/- 1.39 mug/dL) but lower than the battery workers (25.27 +/- 9.82 mug/dL). Urinary NAG (U/gr creatinine) (4.71 +/- 2.11) was lower than the battery workers (7.39 +/- 4.37), however significantly higher than the normal control group (3.07 +/- 1.20). In addition, auto painters had higher levels of Pb exposure and urinary NAG activity than the other workers (p <.05). CONCLUSION: Chronic low dose Pb exposure was found to cause renal tubular injury in children workers of auto repair workshops.