职业性慢性铅中毒患者血铅与血常规及网织红细胞参数相关性分析

目的 了解职业性慢性铅中毒患者血铅与血常规及网织红细胞参数的相关性，为职业性慢性铅中毒辅助诊断和疗效观察提供科学依据。
方法 选择117例职业性慢性铅中毒患者和住院排铅患者为研究组，选取同期来院健康体检的105名正常人为健康体检组，用全自动血细胞分析仪测定两组血常规及网织红细胞参数，分析血铅水平与这些指标的相关性。
结果 铅中毒组网织红细胞（RET）显著高于健康体检组、接铅正常组及铅吸收组（P < 0.05）；三个研究组弱荧光强度网织红细胞（LFR）均高于健康体检组，中荧光强度网织红细胞（MFR）、未成熟网织红细胞指数（IRF）、网织红细胞成熟指数（RMI）均低于健康体检组，差异均有统计学意义（P < 0.05）；铅中毒组强荧光强度网织红细胞（HFR）低于接铅正常组和铅吸收组（P < 0.05）。血铅水平与RET呈正相关（r=0.477，P < 0.01），与血红蛋白（HGB）计数呈负相关（r=-0.203，P < 0.05），与白细胞（WBC）计数呈负相关（r=-0.203，P < 0.05），与血小板（PLT）呈负相关（r=-0.192，P < 0.05）。
结论 职业性慢性铅中毒对患者的血常规及网织红细胞参数存在一定影响，网织红细胞相关参数可作为铅中毒患者的早期辅助诊断指标。

Correlation analysis of blood lead,blood routine and reticulocyte parameters in patients with occupational chronic lead poisoning

Objective To understand the correlation between blood lead,blood routine and reticulocyte parameters in patients with occupational chronic lead poisoning,so as to provide scientific basis for the auxiliary diagnosis of lead poisoning and the evaluation of curative effect in treatment of occupational chronic lead poisoning.Methods Totally 117 patients with occupational lead exposure,including chronic lead poisoning patients and in-hospital lead excretion patients,were selected as the study group,and 105 healthy workers as the physical examination group.The blood routine and reticulocyte parameters were measured by the full-automatic blood cell analyzer.The correlation between blood lead level and parameters of blood routine examination was analyzed.Results The number of reticulocyte(RET)of cases with lead poisoning was significantly higher than that of healthy workers,the normal lead exposure workers and the worker diagnosed as lead absorption(P<0.05).The number of low fluorescent reticulocyte(LFR)of the workers of study group was higher than that of healthy workers(P<0.05),while MFR(middle fluorescent reticulocyte),IRF(immature reticulocyte index)and RMI(reticulocyte maturity index)were lower(P<0.05).The number of high fluorescent reticulocyte(HFR)of cases with lead poisoning was higher than that of heathy workers,while lower than that of the normal lead exposure workers and the workers diagnosed as lead absorption(P<0.05).Blood lead level was positively correlated with RET(r=0.477,P<0.01),negatively correlated with hemoglobin(r=-0.203,P<0.05),negatively correlated with WBC count(r=-0.203,P<0.05),and negatively correlated with platelet count(r=-0.192,P<0.05).Conclusion Occupational chronic lead poisoning had a significant effect on the blood routine and reticulocyte parameters.Reticulocyte related parameters can be used as an early auxiliary diagnostic indicator for lead poisoning patients.