接触正己烷致血清中NSE、NF-L水平改变及与NCV关系研究

目的 研究接触正己烷致血清中神经元特异性烯醇化酶(neuron-specific enolase,NSE)、神经丝轻链蛋白(neuronal light chain protein,NF-L)等早期水平改变特征,并与周围神经传导速度(nerve conduction velocity ,NCV)值改变进行比较,探讨作为效应性生物标志物的可行性。 方法 分析正己烷中毒企业员工,按接触正己烷不同时间段分组,运用方差分析和相关性分析方法,研究指标改变和之间相互关系。 结果 员工接触正己烷时间加权平均浓度为223.0 mg/m³情况下, NSE、NF-L水平随时间逐渐增高,NSE水平组间差异有统计学意义(F=5.96,P=0.001),但NF-L水平组间差异无统计学意义(F=0.99,P=0.40)。最早自1～3个月组别始,NSE水平与对照组比较差异有统计学意义(P＜0.05),但NF-L水平与对照组比较差异无统计学意义(P＞0.05)。各组别人群NCV均随接触正己烷时间增加而减慢,且组间改变差异有统计学意义(P＜0.01),最早自6～9月组别始,与对照组比较减慢差异有统计学意义(P＜0.05),以正中神经、腓总神经运动神经传导速度(motor nerve conduction velocity,MNCV)值改变最明显。NSE水平与正中神经、腓总神经MNCV值呈明显负相关(P＜0.05),与腓肠神经感觉神经传导速度(sensory nerve conduction velocity,SNCV)值呈明显负相关(P＜0.05)。NF-L水平与正中神经NCV值呈明显负相关(P＜0.05)。 结论 NSE可作为正己烷致周围神经损害的效应性生物标志物,早于NCV值改变,作为接触正己烷人群职业健康大规模筛选指标有一定应用价值。

Changes of serum levels of neuron-specific enolase andneuronal light chain protein induced by exposing to n-hexane and their relationships with nerve conduction velocity

Objective To study the characteristics of changes of early levels of serum neuron-specific enolase (NSE), neuronal light chain protein (NF-L) induced by exposing to n-hexane, to compare the above-mentioned changing characteristics with the changes of peripheral nerve conduction velocity (NCV), and to explore their feasibilities as effective biomarkers. Methods Employees with n-hexane poisoning in an enterprise were analyzed according to different exposure time of n-hexane. Variance analysis and correlation analysis were used to study the changes of the indicators and their interrelations. Results When the employees were exposed to the concentration-time weighted average of n-hexane of 223.0 mg/m³, the levels of NSE and NF-L increased gradually with time. There was a statistically significant difference in the NSE level among groups (F=5.96, P=0.001), but no significant difference was found in the NSE level among groups (F=0.99, P=0.40). There were statistically significant differences in the level of NSE between the control group and the groups with 1-3, 6-9 and ≥12 months exposure (P<0.05), but no statistically significant differences was observed in the level of NF-L between the control group and the groups with 1-3, 6-9 and ≥12 months exposure (P>0.05). The levels of NCV of all groups exposed to n-hexane decreased with the increase of the time of exposure to n-hexane; moreover, the changes showed statistically significant differences among all groups (P<0.01). The decrease showed statistically significant differences between the control group and the groups with 6-9 and ≥12 months exposure (P<0.05), and the changes in sensory nerve conduction velocity (MNCV) of median nerve and common peroneal nerve were significant. The level of NSE was significantly negatively correlated with MNCV of median nerve and common peroneal nerve (P<0.05) as well as sensory nerve conduction velocity(SNCV)of sural nerve (P<0.05). The level of NF-L was negatively correlated with NCV of median nerve (P<0.05). Conclusions NSE can be used as an effective biomarker of peripheral nerve damage causedby n-hexane, and it changes earlier than NCV. It has a certain application value to serve as a large-scale occupational health surveillance index in population exposed to n-hexane.