血铅超标对铅作业工人T细胞亚群的影响观察  

Impact of Excessive Blood-lead Levels on T Cell Subsets in Lead Exposed Workers

作　　者：王琳[1] 王谨瑜[2] 白海[3] 李晓凤[1] 万芳[1] 

机构地区：[1]甘肃省白银市第一人民医院(白银有色集团公司职工医院)血液科、职业病科,甘肃白银730900 [2]复旦大学附属华山医院内科,上海200040 [3]兰州军区总医院血液科,甘肃兰州730050

出　　处：《中国实验血液学杂志》2011年第6期1509-1511,共3页Journal of Experimental Hematology

摘　　要：本研究旨在通过临床病例观察探讨铅中毒对接触铅作业工人T细胞免疫功能的影响,为职业病的防治提供依据。2007-2010年通过对大批职业体检者的静脉血和晨尿标本的检测,从中选择血、尿铅等指标超标并需要驱铅治疗者70人中作为观察组,无铅接触的正常健康作业工人60人中作为对照组,并对这2组人员进行T细胞亚群检测、观察和分析。结果发现,观察组70人CD3+CD4+降低者占47.14%,CD4+/CD8+比值低于正常值者占71.43%,其中比值倒置者占41.42%;对照组60人CD3+CD4+降低者占13.33%,CD4+/CD8+比值低于正常值者占25%。观察组血铅浓度(4.63±1.27)μmol/L,CD4+/CD8+比值1.20±0.50,对照组血铅浓度(0.72±0.35)μmol/L,CD4+/CD8+比值1.75±0.62。结论:职业性血铅超标者发生细胞免疫功能低下较正常者明显增加,提示铅可以抑制人体细胞免疫功能。随着职业者血铅浓度的增高,T细胞亚群异常者增加,显示血铅浓度与T细胞免疫功能有关。The aim of this study was to explore the impact of lead poisoning on immunological function of T cell subsets in lead-exposed workers through analysis of clinical cases so as to provide the basis for prevention and treatment of occupational diseases.70 cases who had excessive level of lead in blood and urine and need treatment by driving out lead were collected as observation group through detection of a large blood and urine samples from 2007 to 2010,meanwhile 60 normal healthy people without lead exposure were enrolled in control group.The blood and urine-lead level and T cell subsets in these two groups were detected and analyzed by JP-1A polarograph and flow cytometry respectively.The results showed that among 70 workers in observation group 47.14% had lower CD3^＋CD4^＋ level,71.43% had lower CD4^＋/CD8^＋ ratio,the ratio-inversed cases reached to 41.42%,while 13.33% people had lower CD3^＋CD4^＋ level,25% had CD4^＋/CD8^＋ ratio below normal level in control group.The blood-lead concentration and CD4^＋/CD8^＋ ratio in observation group were（4.63±1.27） μmol/L and 1.20±0.50 respectively;the blood-lead concentration and CD4^＋/CD8^＋ ratio in control group were（0.72±0.35） μmol/L and 1.75±0.62,respectively.It is concluded that the obvious increase of cases with cellular immune dysfunction are observed in occupational workers with excessive blood lead,indicating that the lead can suppress human cellular immune function.Moreover along with increase of blood lead concentration of these workers,more people has abnormal T cell subsets,which shows that the blood lead concentration is associated with immune function of T-cells.

关 键 词：职业性铅暴露 血铅 T细胞亚群 细胞免疫功能 

分 类 号：R135.11[医药卫生—劳动卫生] R595.2[医药卫生—公共卫生与预防医学]