牙科汞合金充填对成年患者健康的影响  

Health Impacts of Amalgam Mercury Exposure on Adults

作　　者：叶细标[1] 许缃 徐培成[3] 朱霖[3] 傅华[1] 

机构地区：[1]复旦大学公共卫生学院预防医学教研室,上海200032 [2]上海市徐汇区疾病预防与控制中心,上海200031 [3]上海市徐汇区牙病防治所,上海200032

出　　处：《复旦学报（医学版）》2005年第4期475-478,共4页Fudan University Journal of Medical Sciences

摘　　要：目的分析牙科汞合金充填对成人健康的影响。方法128名牙科汞合金充填者与128名对照作为研究对象。测定尿中汞、白蛋白(ALB)、β2微球蛋白尿(β2-MG)和N-己酰-β-D-氨基葡萄糖苷酶(NAG)水平,并用尿肌酐进行校正。WHO核心测试组合评价情感状态和神经行为功能。结果充填组的平均尿汞水平为4.34nmolHg/mmolCr,显著高于对照组的平均水平(3.57nmolHg/mmolCr,P=0.000)。汞合金充填面数量、喜烫食习惯、磨牙习惯以及性别是影响汞释放的主要因素。充填组与对照组肾功能指标没有统计学差异。不论充填数多少和充填时间长短,均未发现情感状态的改变。虽然充填组复杂反应耗时比对照组多,符号译码总操作次数和正确次数比对照组低,但多元回归分析显示这种改变与充填数无关。结论虽然牙科汞暴露可以增加机体汞负荷,本研究表明目前的暴露水平下还不会导致明显的肾脏和神经系统损害。Purpose To explore health impacts of amalgam mercury exposure on adults. Methods One hundred and twenty-eight medical college students and teachers with amalgam (amalgam group) and 128 doctors without amalgam (control group) were selected.Spot urine samples were collected and tested for levels of mercury (UHg),creatinine (UCr), albumin (UALB),β2-microglobulin(Uβ2-MG)and N-acetyl-β-D-glucosaminidase(UNAG).All urinary biomarkers were adjusted by creatinine.Computerized WHO/NCTB system(NES-C3) and POMS questionnaire were used to evaluate neurobehavioral effects. Results Statistically significant elevated urinary mercury level was found among amalgam group,4.34 nmol Hg/mmol Cr and 3.57 nmol Hg/mmol Cr respectively.Number of amalgam face,hot-eating habit,odontoprisis and sex were major predictors of urinary mercury levels.No differences were found for renal biomarkers between two groups.Compared to control group,no difference were found for mood status(POMS) among amalgam subgroups with various amalgam faces and duration.More Benton Visual Retention time,less total and correct Symbol-digit substitution operation were found among amalgam group.However,these changes couldn't be explained by amalgam amount. Conclusions Although amalgam mercury exposure elevated body mercury burden,no significant clinical health impacts of renal and nervous systems were induced.

关 键 词：汞合金充填 牙科 患者健康 氨基葡萄糖苷酶 β2微球蛋白尿 成年 神经行为功能 核心测试组合 多元回归分析 神经系统损害 情感状态 统计学差异 肾功能指标 对照组 成人健康 研究对象 平均水平 复杂反应 暴露水平 白蛋白 

分 类 号：R781.05[医药卫生—口腔医学] R783.1[医药卫生—临床医学]