CAJ | 학술논문

目的探索铅作业人员神经系统早期损伤的敏感指标,为建立有效的职业健康监护路径和方案提供科学依据.方法采用原子吸收光谱法对317名铅作业人员血铅值进行检测,血铅值范围为26.90～912.80 μg/L,根据血铅正常值(201μg/L),可接受上限值(400 μg/L)和诊断值(600 μg/L)将接铅人员分为4个组,采用单因素方差分析对运动神经传导功能进行检查和分析.结果正中神经各组末端潜伏期、波幅之间差异有统计学意义,其中血铅最高剂量(＞600 μg/L)组末端潜伏期均值为3.63 ms,明显长于总均值3.30 ms;波幅均值为5.63 μV,明显低于总均值7.27 μV.各组运动传导速度之间差异无统计学意义.尺神经各组波幅之间差异有统计学意义,其中血铅最高剂量组波幅为4.31 μV,明显低于总均值4.87 μV.其他参数之间无显著性差异.结论正中神经的运动神经传导末端潜伏期和波幅指标可作为接铅作业人员神经系统早期亚临床损伤的最敏感客观指标.
목적 탐색연작업인원신경계통조기손상적민감지표,위건립유효적직업건강감호로경화방안제공과학의거.방법 채용원자흡수광보법대317명연작업인원혈연치진행검측,혈연치범위위26.90～912.80 μg/L,근거혈연정상치(201μg/L),가접수상한치(400 μg/L)화진단치(600 μg/L)장접연인원분위4개조,채용단인소방차분석대운동신경전도공능진행검사화분석.결과 정중신경각조말단잠복기、파폭지간차이유통계학의의,기중혈연최고제량(＞600 μg/L)조말단잠복기균치위3.63 ms,명현장우총균치3.30 ms;파폭균치위5.63 μV,명현저우총균치7.27 μV.각조운동전도속도지간차이무통계학의의.척신경각조파폭지간차이유통계학의의,기중혈연최고제량조파폭위4.31 μV,명현저우총균치4.87 μV.기타삼수지간무현저성차이.결론 정중신경적운동신경전도말단잠복기화파폭지표가작위접연작업인원신경계통조기아림상손상적최민감객관지표.
Objective To find a sensitive index of early injury of the nervous system in lead-exposed workers and to provide a scientific basis for establishing an efficient occupational health surveillance route.Methods A total of 317 lead-exposed workers (blood lead levels:26.90～912.80 μg/L,determined with the atomic absorption spectrum) were divided into four groups according to the normal blood lead level (201 μg/L),acceptable upper limit of blood lead (400 μg/L),and diagnostic value (600 μg/L).The motor nerve conduction function was examined and analyzed by one-way ANOVA.Results The distal latency and amplitude of the median nerve were significantly different between groups.The median distal latency of the highest blood lead group (＞600 μg/L) was 3.63 ms,which was significantly longer than the average level (3.30 ms),and the median nerve amplitude of the highest blood lead group was 5.63 μV,significantly lower than the average level (7.27 μV).No significant difference was found between different groups in motor conduction velocity.Significant difference was found in ulnar nerve amplitude between groups.The ulnar nerve amplitude of the highest blood lead group was 4.31 μV,significantly lower than the average level (4.87 μV).No significant differences were observed in other parameters between groups.Conclusion The distal latency and amplitude of the median nerve can be used as a sensitive index for the diagnosis of early subclinical motor nerve injury in lead-exposed workers.