镉接触工人尿镉血镉与尿β_2MG RPB含量的跟踪研究

目的:跟踪调查镉接触工人停止接触镉后尿镉、血镉的变化及肾功能损害情况,寻找镉接触指标与肾功能损害指标的关系,初步探讨职业性镉引起的肾功能特点及规律。方法:选择深圳某镍镉电池厂29名镉中毒观察对象(尿镉连续2次超过5μmol/mol肌酐)为研究对象,分析尿镉、血镉含量与尿β2-微球蛋白(β2MG)、尿视黄醇结合蛋白(RPB)排出量的关系;并通过跟踪研究他们在停止接触镉1年后,接触指标(尿镉、血镉)及肾功能损害指标的变化的规律。结果:镉中毒观察对象在停止接触1年后,尿镉由(7.16±2.81)μmol/mol肌酐下降至(7.03±2.84)μmol/mol肌酐,尿镉含量下降没有显著性差异(P>0.05);血镉明显下降,由(5.8±1.81)μg/L下降至(3.5±1.24)μg/L,有显著性差异(P<0.01);尿β2-微球蛋白含量(中位数)由1.19μmol/mol肌酐上升至1.21μmol/mol肌酐,尿视黄醇结合蛋白含量(中位数)由0.39μmol/mol肌酐上升至0.42μmol/mol肌酐,统计学秩和检验结果显示均没有显著性差异(P>0.05)。尿镉与血镉存在明显的线性正相关,相关系数(r)为0.721,(P<0.01),回归分析得出的方程为:y=1.132x+3.656,(y代表尿镉,x代表血镉)。尿镉、血镉与尿β2-微球蛋白含量的相关系数分别为0.321,0.346,统计学上均没有显著性相关(P>0.05)。结论:职业性镉中毒观察对象停止接触镉1年后,血镉明显下降,尿镉含量下降不明显,尿镉与血镉存在线性正相关,尿β2-微球蛋白、尿视黄醇结合蛋白含量总体水平变化不显著,但有个别仍可以出现肾功能异常,镉对肾功能损害存在明显个体差异性。

Follow-up study on the urinary Cd blood Cd β2MG and RBP in urine of the Cadmium exposure workers

Objective: In order to explore the earlier indicators for renal dysfunction,an occupational epidemiological study was conducted to investigate the relationship between the cadmium(Cd) exposure and the renal dysfunction.UCd of the cadmium exposure workers' children was also observed Methods:To investigate the prognosis of renal dysfunction of workers removal from cadmium exposure.Twenty-nine workers whose urinary cadmium above 5 μg/g Cr were followed up for one year after exposure removal.Urinary cadmium,blood cadmium β_(2~-) microglobuin and retinol binding protein(RBP) were analyzed in 2004 and 2005,respectively.The relationship between urinary Cd concentration and concentrations of β_(2~-)microglobulin(β_2MG),retinal binding protein(RBP) in urine were investigated.Results: Twenty-nine workers whose urinary cadmium were above 5 μg/g Cr were followed up for one year after exposure removal.Blood cadmium of those workers decreased,but Urinary cadmium,β_(2~-) MG and RBP of those workers had no significant change(P>0.05).There was no significant linear relationship between urinary Cd concentration and the concentrations of β_2MG and retinal binding protein(RBP) and in urine(P>0.05),but there was significant linear relationship between urinary Cd concentration and blood cadmium concentration.(r=0.721,P<0.01) Conclusion: After one year exposure removal.Blood cadmium of those workers decreased, but Urinary cadmium,β_(2~-) MG and RBP of those workers had no significant change Renal dysfunction among the workers whose urinary cadmium above 5 μg/g Cr,will not stop even one-year removal from cadmium exposure.There is no significant linear relationship between urinary Cd concentration and the concentrations of β_2MG and retinal binding protein(RBP) and in urine.