低浓度丙烯腈(AN)对作业工人血管内皮功能的影响  

Effect of low concentration acrylonitrile(AN) on endothelium function of occupationally exposed workers

作　　者：张志华[1] 龚辉[1] 莫为春[1] 黄国倩[2] 

机构地区：[1]复旦大学附属金山医院心内科,上海200540 [2]复旦大学附属华山医院心内科,上海200040

出　　处：《复旦学报（医学版）》2012年第2期162-165,共4页Fudan University Journal of Medical Sciences

摘　　要：目的探讨低浓度丙烯腈(acrylonitrile,AN)对职业接触工人肱动脉内皮功能的影响。方法随机抽取某腈纶厂50名作业工人[男性35人,女性15人,平均年龄(46.36±7.66)岁]作为接触组,同时选取不接触任何毒物的50名普通工人[男性31人,平均年龄(46.42±7.19)岁]作为对照组,利用高频彩色多谱勒超声测量静息状态下、反应性充血后、舌下含服硝酸甘油后的肱动脉内径(分别记作D0、D1、D2),并计算反应性充血和硝酸甘油诱发的内径百分变化率,由此判断肱动脉血流介导的内皮依赖性舒张功能(flow mediated dilation,FMD)及硝酸甘油介导的非内皮依赖性舒张功能(nitroglycerin mediated dilation,NMD),3年后重复上述检查随访内皮功能。数据采用Intercooled Stata 10.0软件分析。结果 3年后随访接触组内皮功能,其指标明显低于入选当年(FMD,7.62%±3.67%vs.10.13%±2.94%,P<0.01;NMD,24.99%±8.45%vs.28.44%±6.18%,P<0.05),且明显低于对照组(FMD,7.62%±3.67%vs.14.40%±4.29%,P<0.01;NMD,24.99%±8.45%vs.33.82%±6.12%,P<0.01);对照组检查入选当年与随访第3年的FMD和NMD均未存在明显差异(P>0.05)。结论长期低浓度AN对职业接触人群的血管内皮功能存在一定损害;高分辨超声检测肱动脉FMD可用于AN接触工人早期血管功能的检测。Objective To study the impact of low concentration of acryloitrile （AN） on endothelial function of brachial artery in occupationally exposed workers. Methods Exposed group consisted of 50 workers [35 males, 15 females, mean age （46.36 ± 7. 66） years] exposed to low concentration acrylonitrile, and matched workers [31 males, 19 females,mean age （46.42 ± 7.19） years] who had not been exposed to any chemistry poison were enrolled as control group. The diameters of the brachial artery were measured at rest （D0）, in reactive hyperemia （DI） and after nitroglycerin administration （D2） by color Doppler uhrasonography respectively. We caculated the inner percentage rate after reactive hyperemia and sublingual nitroglycerin, and estimated the flow mediated dilation （FMD） and nitroglycerin mediated dilation （NMD）. The data of endothelial function in the first year and the third year were collected and analyzed with Intercooled Stata 10.0. Results In the third year,FMD and NMD in exposed group were significantly lower than those in the first year （FMD,7.62% ＋ 3. 67% vs. 10.13% ＋2.94%,P〈0.01;NMD,24.99%±8.45% vs. 28.44% ±6.18%,P〈0.05）;and were also apparently lower than those in control group （FMD,7.62% ± 3.67% vs. 14. 400% ＋ 4.29% ,P〈0.01 ;NMD,24.99% ± 8.45% vs. 33.82% ± 6.12%,P〈0.01）. However,FMD and NMD in control group were not changed during follow-up （P 〉 0. 05 ）. Conclusions Long-term exposing to low- concentration acrylonitrile is harmful to the endothelium function of the professional workers, which can be detected early by using color Doppler ultrasonography.

关 键 词：丙烯腈(AN) 血管内皮功能 彩色多谱勒超声 工人 

分 类 号：R136.32[医药卫生—劳动卫生]