慢性汞暴露对接触者人群肾小球功能影响

目的 探讨慢性空气汞暴露对人群肾小球功能的影响。方法 选择某温度计厂为研究现场,根据生产车间空气汞监测数据,将全厂职工划分为暴露组(n=101)和对照组(n=85);测定186名职工发汞、尿汞以及肾小球功能,并对职工进行问卷调查。结果 暴露组空气汞浓度、尿汞、发汞和累积暴露量明显高于对照组(P<0.01);暴露组血清肌酐浓度为(81.6±43.9)μmol/L,明显高于对照组(65.6±36.6)μmol/L;暴露组内生肌酐清除率(81.6±39.7)mL/min,明显低于对照组(113.4±45.4)mL/min;多元分析结果显示,随发汞的升高,血清肌酐明显升高,内生肌酐清除率明显降低;随累积接触量增加,血清肌酐和血清尿素氮均明显升高。结论 肾小球滤过功能指标的改变与反映长期暴露量的发汞和累积暴露量关系密切,可作为反映汞暴露对肾脏功能长期损害的指标。

Adverse effects of chronic exposure to mercury vapor on human renal glomerulus function

Objective To explore adverse effects of chronic exposure to mercury vapor on human renal glomerulus function.Methods A thermometer plant was selected as research field in this study and the staff in the plant was divided into groups of exposure and control according to mercury concentration in the air of workplace.Mercury in urine and hair and renal glomerulus function of 186 workers were determined, and a questionnaire survey on workers health status was also conducted.Results Mercury levels in urine and hair and cumulative exposure index in the exposure group were higher than those of in the control group significantly(P<0.01).Serum creatinine(Scr) in the exposed group(81.6±43.9 mol/L) was significantly higher than that of in the control group(65.6±36.6 μmol/L).Endogenous creatinie clearance rate(C cr) in the exposed group(81.6±39.7 mL/min) was significantly lower than that of in the control group(113.4±45.4 mL/min).Multiple regression analyses showed that Scrincrea sed and C cr decreased significantly with the increment of mercury in the hair.On the other hand, both Scr and blood urea nitrogen increased when cumulative exposure index increased.Conclusion The change of renal glomerular filtration function is closely correlated with chronic mercury cumulative exposure indices and mercury content in the hair and could be used as an indicator of long term renal function damage caused by murcury exposure.