锰接触工人脑磁共振成像改变及血某些微量元素含量的研究  

Study on the brain MRI alterations and the levels of Mn,Mg,Zn,Fe,Ca and Cu in blood of Mn-exposed workers

作　　者：杜凤其[1,2] 莫雪安[1] 姜岳明[3] 龙莉玲[4] 李向荣[4] 傅雪[3] 

机构地区：[1]广西医科大学第一附属医院神经内科,广西南宁530021 [2]广州市海珠区第一人民医院神经内科,510220 [3]广西医科大学卫生毒理学教研室,530021 [4]广西医科大学第一附属医院放射科,530021

出　　处：《中国职业医学》2009年第3期181-184,共4页China Occupational Medicine

基　　金：中意科技合作交流项目(2002-389H30);国家十一五科技支撑计划<职业病;地方病的防控研究>重点项目(2006BAI06B02);广西科学研究与技术开发计划项目(桂科合0443004-42)

摘　　要：目的探讨长期锰接触工人脑锰蓄积及其与血Mn、Mg、Zn、Fe、Ca、Cu含量变化的关系,为锰中毒早期诊断及防治提供科学依据。方法选择广西某厂锰接触无症状冶炼工人13例(接锰平均浓度0.76mg/m3)、锰中毒工人4例(均已脱离锰接触20年以上)、非锰接触对照工人6例,采用美国GE公司生产的GE signa1.5MR/i超导磁共振成像(MRI)仪依次进行轴位FSET2加权像(WI)、轴位T1 flair T1WI、冠状位或矢状位T1 flair T1WI检查,在轴位T1 flair T1WI上测量苍白球和同侧额叶白质的信号强度,根据公式苍白球指数(PI)=苍白球信号强度/额叶白质的信号强度×100%来计算。采用电感偶合等离子发射光谱法(ICP-AES)测定血Mn、Mg、Zn、Fe、Ca、Cu含量。结果锰接触、中毒组分别有92.3%、25.0%的工人苍白球MRI T1WI信号增强、T2WI信号正常,锰接触工人PI平均值显著高于对照组及锰中毒组(P<0.01)。锰接触工人红细胞锰(RBCMn)分别与PI、血锰(MnB)呈正相关(P<0.05)。结论苍白球MRI T1WI高信号可反映近期锰接触,PI可反映锰在中枢神经系统蓄积,PI和RBCMn含量可作为锰神经毒性的早期暴露生物标志物。Objective To investigate the relationship between brain MRI and the levels of Mn,Zn,Cu,Fe,Ca and Mg in the blood of workers exposed to manganese （Mn） in a long-term, and provide the scientific basic on diagnosis,treatment and prevention of manganese poisoning. Methods Brain MRI examination and metal dements measurement were performed in 13 asymptomatie Mn-expesed workers ,4 manganism patients and 6 healthy volunteers. MRI examination performed on a 1.5 T signa superconducting system （ GE company, USA）. Signal intensity in T1-weighted （ T1 WI） imaging was measured on globus pallidus （GP） and the frontal white matter （ FW）, respectively （ PI = SIGP/SIFW × 100% ）. The concentration of metal elements was measured by ICP-AES. Results The Mn-exposed workers showed a high signal in T1 WI and a normal signal in T2 WI, differences of the mean in PI among three groups were significant （ P 〈 0.01 ）. The concentration of Mn in RBC （RBCMn） of Mn-exposed workers was higher than that of the other two groups. Conclusion High signal in GP on the T1 WI image may reflect recent exposure to manganese. PI index indicates Mn cumulation in centre nerve system. PI and RBCMn may be used as an early exposure biomarker of Mn neurotoxicity.

关 键 词：锰接触 磁共振成像 苍白球指数 金属元素 

分 类 号：R135.1[医药卫生—劳动卫生]