职业性铅暴露与椎体骨折的关系

[目的]利用铅暴露工人楔形骨折、终板骨折、压缩性骨折等轻度腰椎椎体骨折的腰椎摄片资料，调查职业性铅暴露与椎体骨折的关系。[方法]以上海某蓄电池厂175名铅作业工人为暴露组，同时选取该厂无职业性铅暴露史的工人60名为对照组，对2组进行腰椎摄片和血铅浓度检测，统计分析腰椎椎体骨折的发生特点及铅暴露与骨折发生的关系。[结果]铅暴露组中发生轻度及以上椎体骨折的人数为112人，发生率64％；中度及以上椎体骨折30人，发生率17％。暴露组175人中，楔形骨折者42人，占24．0％；终板骨折者91人，占52．0％；压缩性骨折者27人，占15．0％。对照组中发生有轻度及以上椎体骨折的人数为27人，占45．0％；中度及以上椎体骨折者2人，占3.3％。其中楔形骨折者9人，占15．0％；终板骨折者20人，占33.3％；压缩性骨折者6人，占10．0％。经统计学检验，轻度及以上和中度及以上椎体骨折发生率，暴露组均明显高于对照组，差异有统计学意义（χ2=6．68，P=0．014；χ2=7．24，P=0．008）。在轻度及以上骨折的3种表现类型上，终板骨折在暴露组和对照组中有明显差异（χ2=6．25，P=0．016）。铅暴露工人中随着体内铅暴露水平的升高，轻度及以上椎体骨折的发生率和严重程度呈增加趋势，高血铅（≥1．21μmol／L）组椎体轻、中度及以上骨折的发生率均明显高于低血铅（〈1．21μmol／L）组，P值分别为0．000和0．008。[结论]职业性铅暴露工人中椎体骨折发生率增加。

Research on the Relationship between Occupational Lead Exposure and the Vertebral Fractures

[ Objective ] To investigate the effects of occupational lead exposure on the vertebral fracture. [ Methods ] A total of 175 lead exposure workers and 60 non-lead exposure workers in a storage battery plant were chosen as research subjects and controls. Data were gained by the abdominal vertebra X-ray photographs and measurement of blood lead concentration. [ Results ] Among 175 lead expusure workers, there were 112 （64%）light vertebral fractures, 30（ 17% ）moderate vertebral fractures. There were 42 （ 24.0% ）wedge fractures, 91 （52.0%） endplate fractures and 27 （ 15.0% ）compression fractures in 112 light vertebral fractured lead exposure workers. Among 60 non-lead expusure workers, there were 27 （ 45.0% ） light vertebral fractures, 2 （ 3.3% ） moderate vertebral fractures. There were 5 （ 15.0% ） wedge fractures, 20 （ 33.3% ） endplate fractures and 6 （ 10.0% ）compression fractures in 27 light vertebral fractured non-lead exposure workers.The vertebral fracture rate in the occupational lead exposure group were higher than that in the control group with significantly statistical difference （χ2=6.68, P=0,014 ）. Among lead exposure workers and those who had high blood lead concentration, the vertebral fracture rate was significantly increased in the groups of ≥1.21μmol/L blood lead concentration. [ Conclusion ] Occupational lead exposure can cause the increase of the vertebral fracture.