ALAD基因多态性对职业铅接触工人甲状腺激素水平的影响

[目的]研究δ-氨基乙酰丙酸脱水酶（ALAD）基因多态性对职业铅接触工人甲状腺激素水平的影响。[方法]采集171名上海市某蓄电池厂职业铅接触工人外周静脉血样，用放射免疫测定法（RIA）测定工人甲状腺激素水平，包括T3、FT3、T4、FT4和TSH。聚合酶链反应-限制性片段长度多态性（PCR—RFLP）对ALAD基因进行分型分析，限制性内切酶为MspⅠ，并分析甲状腺激素水平与ALAD基因型的关系。[结果]171名工人中ALAD1-1纯合子基因型工人156名，基因型频率为91．23％；ALAD1-2杂合子基因型工人15名，基因型频率为8．77％；未检测出有ALAD2-2纯合子基因型工人。等位基因ALAD1和ALAD2的频率分别为95．61％和4．39％。协方差分析，ALAD1-2基因型工人PbB水平为1．06（0．87-1．24）μmol／L，明显比ALAD1-1基因型工人PhB水平0．77（0．72—0．83）μmol／L高，（F=8．14，P〈0．05）。高血铅组工人（PbB≥0．97μmol／L）与低血铅组工人（PbB〈0．97μmol／L）相比，甲状腺激素中除了FT4水平略有升高以外，T3、FT3、T4和TSH均是高血铅组工人低干低血铅组工人。ALAD1-2基因型组工人和ALAD1-1基因型组工人相比．T3、FT3和TSH的水平下降比较明显，而T4和FT4水平没有很大差异或是略有升高。低血铅组和高血铅组，都是ALAD1-2基因型工人的T3、FT3和TSH比ALAD1-1基因型工人的低，而T4和FT4的平均水平差不多或是略有升高。[结论]ALAD2等位基因可使工人体内血铅水平增高，增加体内铅负荷；在相同铅负荷下，ALAD2等位基因有加重铅对工人甲状腺功能影响的趋势，但需要扩大样本量进行验证。     

铅对作业工人某些内分泌腺功能影响的研究

本文研究发现铅吸收、铅中毒工人血中游离三碘甲状腺原氨酸（ＦＴ＿３）、游离四碘甲状腺原氨酸（ＦＴ－４）、皮质醇含量明显低于对照组工人（Ｆ＜０．０１），且与尿铅、尿δ－ＡＬＡ含量呈明显负相关；铅中毒工人血中ＴＳＨ明显高于对照组工人（Ｐ＜０．０１），且与尿铅、尿δ－ＡＬＡ含量呈明显正相关。结果提示，接铅工人体内铅负荷达铅吸收水平，但尚未产生中毒症状时就已影响了甲状腺、肾上腺皮质的分泌功能，说明某些内分泌腺对铅的损伤作用较敏感，铅损伤某些内分泌腺的功能可能是铅中毒的重要机理之一。     

郑州市体检人群甲状腺激素水平异常情况分析

目的 分析郑州市体检人群甲状腺激素水平异常情况,为甲状腺疾病防治提供指导信息。方法 以2020年7—12月郑州市某三甲医院健康体检者作为研究对象进行资料收集、体格检查及甲状腺激素等血生化指标检测,分析该人群甲状腺激素水平异常情况,并采用单、多因素分析方法对甲状腺激素水平异常影响因素进行分析。结果 本研究共对2 982名健康体检者进行研究,男性1 476人,女性1 506人,男女性别比为1∶0.98。年龄18~67岁,平均（40.15±6.89）岁。BMI 17.6~26.9,平均（23.1±2.6）。检出甲状腺激素水平异常405例,异常检出率为13.58%。甲状腺功能亢进、甲状腺功能减退、亚临床甲状腺功能亢进及亚临床甲状腺功能减退分别检出25、71、56、253例,检出率分别为0.84%、2.38%、1.88% 、8.48%。多因素Logistic回归分析结果显示,女性（OR=1.988）、年龄越大（OR=2.221）、BMI≥24.0（OR=2.125）、有甲状腺疾病史（OR=3.640）、血脂异常（OR=3.053）是甲状腺激素水平异常的危险因素。结论 郑州市体检人群甲状腺激素水平异常率较高,异常情况以亚临床甲状腺功能减退为主,甲状腺激素水平异常影响因素较多,在健康体检中进行甲状腺激素水平检查有利于及早发现甲状腺功能异常,具有重要的防治意义。     

早产儿游离甲状腺素的测定及意义

目的了解早产儿甲状腺功能,有助于临床治疗.方法用固相化免疫放射法测FT3、FT4,用免疫放射法测TSH.结果早产儿组FT3、FT4明显低于足月儿组,P分别＜0.005和＜0.05,TSH两组无显著差异.孕周≤33周组FT3明显低于＞33周组(P＜0.01).体重≤2 000 g组FT3明显低于＞2 000 g组(P＜0.05).不同孕周组和体重组的早产儿FT4和TSH均无显著性差异.结论早产儿甲状腺功能明显低于足月儿,而且与胎龄和出生体重密切相关.     

甲状腺激素对妊娠期糖尿病患者甲状腺标志物的影响

目的 探讨血清游离三碘甲腺原氨酸(FT₃)、游离甲状腺素(FT₄)、促甲状腺激素(TSH)及FT₃/FT₄比值与妊娠期糖尿病(GDM)的关系。方法 回顾性分析横店文荣医院于2019年1月—2022年12月期间收治的78例GDM孕妇和82例健康孕妇(对照组)的临床资料。logistic回归分析甲状腺标志物(TSH、FT₃、FT₄及FT₃/FT₄)与GDM的关系。结果 两组间相比,对照组年龄(29.2±6.2)岁、低FT₄(0.89±0.19)ng/dl、高TSH(1.82±0.57)μ/L,GDM组具有高龄(32.2±5.4)岁、低FT₄(0.74±0.09)ng/dl、高TSH(2.39±0.64)μ/L的特征,差异均有统计学意义(均P<0.05)。logistic回归分析显示,孕周、空腹血糖、糖化血红蛋白及FT₃/FT₄     

有机锡对甲状腺激素水平影响的初步探讨

目的　研究有机锡对甲状腺激素水平的影响。方法　选择１７ 名接触有机锡的工人为观察组,未接触有机锡的正常体检者为对照组,测定两组工人血清Ｔ３ 、ｒＴ３ 、Ｔ４ 和ＴＳＨ 水平。结果　观察组Ｔ３ 明显低于对照组,而ｒＴ３ 明显高于对照组,但Ｔ４ 和ＴＳＨ 无显著性差异。结论　有机锡对甲状腺激素的分泌、代谢等过程可能有影响。     

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。     

早产儿游离甲状腺素的测定及意义

目的 :了解早产儿甲状腺功能 ,有助于临床治疗。方法 :用固相化免疫放射法测 FT3、 FT4 ,用免疫放射法测 TSH。结果 :早产儿组 FT3、 FT4 明显低于足月儿组 ,P分别 <0 .0 0 5和 <0 .0 5 ,TSH两组无显著差异。孕周≤ 33周组 FT3明显低于 >33周组 ( P<0 .0 1)。体重≤ 2 0 0 0 g组 FT3明显低于 >2 0 0 0 g组 ( P<0 .0 5 )。不同孕周组和体重组的早产儿 FT4 和 TSH均无显著性差异。结论 :早产儿甲状腺功能明显低于足月儿 ,而且与胎龄和出生体重密切相关     

铅对作业工人心血管系统影响的调查研究

铅是一种常见的重金属毒物。铅对人体血液系统、神经系统、肾脏方面的危害已有大量文献报道，而对心血管方面的改变文献报道不多。本文对从事铅冶炼作业人员着重进行了心电图等检查，以探讨铅对心血管系统危害，兹报告如下。１对象与方法１．１对照以某冶炼厂２００名冶炼工人为观察对象。其中男１７５人，女２５人，年龄２０～５８岁，平均３４岁。工龄１～３３年，平均１４年。另外，选１５０名医生、机关工作人员作对照组，年龄１８～６０岁，平均３６岁。１．２方法采用日本光电公司６５１１型心电图机，按常规９个导联心电图检查，以全…     

妊娠晚期妇女异常心电图与甲状腺素水平的相关性分析

目的探讨妊娠晚期妇女异常心电图结果及与甲状腺素水平之间的相关性。方法分析2015年1月-2016年5月在中山大学附属第八医院就诊的57例妊娠晚期妇女的临床资料列为观察组,将64例在本院进行健康检查的妇女作为对照组。比较两组患者心电图异常结果及TSH、FT3、FT4水平,并分析妊娠晚期妇女心电图异常患者TSH、FT3、FT4水平。结果观察组患者心电图异常结果发生率85.96%,明显高于对照组的20.31%,差异有统计学意义(P0.01),其中短P-R间期、窦性心动过速发生率高于对照组,差异有统计学意义(P0.05);观察组患者TSH、FT3、FT4水平显著低于对照组,差异有统计学意义(P0.05);观察组心电图异常患者FT4、TSH水平低于心电图正常患者,差异均有统计学意义(P0.05)。结论妊娠晚期妇女心电图容易发生异常改变,其中以短P-R间期、窦性心动过速为主,FT4及TSH水平降低可能参与了心电图异常结果的发生。     

Neurophysiological studies on workers exposed to lead

Nerve conduction and somatosensory evoked potential studies were undertaken on 46 workers exposed to a combination of organic and inorganic lead. In addition electroencephalograms were carried out on 20 of the workers; the results were compared with those obtained for workers not exposed to lead. The workers exposed to lead had a mean blood lead concentration of 2.35 mumol/l (48.7 micrograms/100 ml), whereas the concentration for workers not exposed to lead was 0.76 mumol/l (15.8 micrograms/100 ml). The mean maximum motor conduction velocities of the median and the posterior tibial nerves were significantly lower in the workers exposed to lead than in the controls. Similarly, the distal latency for these two nerves was significantly prolonged for the workers exposed to lead. No significant differences for the two groups of workers were seen in the nerve conduction and distal latency measurements of the median (sensory) and the sural nerves. The EEG studies of the 20 workers exposed to lead showed no abnormalities. The somatosensory evoked potential of the median (sensory) and posterior tibial nerves were significantly prolonged when measured at the negative and positive deflections. The results suggest that, in addition to nerve conduction velocities, somatosensory evoked potential and distal latency are suitable measurements to detect subclinical neurological damage among workers exposed to lead. As these changes were seen at blood lead concentrations of 2.35 mumol/l (48.7 micrograms/100 ml) there may be a need for more stringent monitoring of workers exposed to lead.     

职业性铅暴露人群血铅的危险因素研究

目的探讨职业铅暴露人群血铅的危险因素,为采取针对性的防控措施提供科学依据。方法选择余姚市蓄电池工厂227名工人作为研究对象,采用统一调查表对个人职业史、生活习惯、教育程度等进行调查,同时进行血铅和车间空气中铅浓度测定。在此基础上,分别采用单因素、多因素条件logistic回归分析筛选血铅的关联因素,P<0.05为差异有统计学意义。结果本研究共设29个检测点,仅5个点合格,合格率17.24%,工人平均血铅水平为(578.54±175.56)μg/L。单因素条件logistic回归分析显示性别、吸烟、户籍、文化程度和车间空气铅浓度等变量均可影响血铅浓度。多因素条件logistic回归分析显示车间空气铅浓度和户籍差异有统计学意义。结论工作场所铅浓度较高,工人血铅普遍较高,车间空气铅浓度和户籍是血铅增高的危险因素。     

Study of the lipoprotein pattern among workers exposed to lead

Occupational exposure to lead fumes constitutes a serious problem in Egypt, since a considerable number of workers might be involved in its deleterious effect. The present study aimed to elucidate the effect of lead exposure on the lipoprotein pattern of exposed workers. The study has been carried out in a plant manufacturing lead batteries. It consists of 89 workers exposed to lead and 25 control subjects. Fasting blood samples were collected for the determination of serum lipoprotein pattern and their cholesterol and phospholipid content. Levels of lead in blood and delta amino levulinic acid in urine have been determined as biological indices of lead exposure. Lead exposure caused mainly a cumulative effect on the cholesterol and phospholipid content of lipoproteins since only workers exposed for more than 10 years showed significant changes. These changes might be referred to the effect of lead exposure on liver and/or on trace metal metabolism.     

铅致职业接触人群遗传损伤效应的研究

目的应用彗星试验和微核试验研究铅致职业接触人群遗传损伤效应。方法3家蓄电池厂的187名职业接触铅工人作为铅接触组,同时选择某镇无铅和其他职业危害接触史的村民179人作为对照组,进行彗星试验和微核试验。结果铅接触组彗星率、彗尾长度和微核细胞率均大于对照组,且差异有统计学意义(P<0.001);随着血铅或尿铅水平的增高,彗星率有增高趋势,微核细胞率仅在血铅>1.45μmol/L组或尿铅>0.58μmol/L组与对照组比较差异有统计学意义(P<0.001)。结论铅可引起职业接触人群遗传损伤,彗星试验可作为铅职业接触人群遗传损伤效应的检测方法。     

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。     

Neurophysiological studies on workers exposed to lead.

Nerve conduction and somatosensory evoked potential studies were undertaken on 46 workers exposed to a combination of organic and inorganic lead. In addition electroencephalograms were carried out on 20 of the workers; the results were compared with those obtained for workers not exposed to lead. The workers exposed to lead had a mean blood lead concentration of 2.35 mumol/l (48.7 micrograms/100 ml), whereas the concentration for workers not exposed to lead was 0.76 mumol/l (15.8 micrograms/100 ml). The mean maximum motor conduction velocities of the median and the posterior tibial nerves were significantly lower in the workers exposed to lead than in the controls. Similarly, the distal latency for these two nerves was significantly prolonged for the workers exposed to lead. No significant differences for the two groups of workers were seen in the nerve conduction and distal latency measurements of the median (sensory) and the sural nerves. The EEG studies of the 20 workers exposed to lead showed no abnormalities. The somatosensory evoked potential of the median (sensory) and posterior tibial nerves were significantly prolonged when measured at the negative and positive deflections. The results suggest that, in addition to nerve conduction velocities, somatosensory evoked potential and distal latency are suitable measurements to detect subclinical neurological damage among workers exposed to lead. As these changes were seen at blood lead concentrations of 2.35 mumol/l (48.7 micrograms/100 ml) there may be a need for more stringent monitoring of workers exposed to lead.