镍铬合金烤瓷冠配戴者尿镍、铬水平和肾功能的关系分析  

Analysis of the association between renal function parameters and urinary nickel or chromium in patients with dental restoration of nickel-chromium alloys

作　　者：曹新明 王珏 夏刚[2] 黄埔[2] 姜庆五[2] 陈波[2] 

机构地区：[1]上海市口腔病防治院口腔修复科,上海200001 [2]复旦大学公共卫生学院教育部公共卫生安全重点实验室,上海200032

出　　处：《上海口腔医学》2012年第3期312-316,共5页Shanghai Journal of Stomatology

摘　　要：目的：探讨镍铬合金烤瓷冠配戴者中的尿镍和尿铬水平是否与机体的肾功能损伤有关。方法：对795例镍铬合金烤瓷冠配戴者进行烤瓷冠修复的问卷调查,尿镍、铬测定和血、尿肾功能生化指标测定,采用SPSS12.0软件包进行t检验、单因素方差分析和Logistic回归分析,探讨尿镍、铬水平与肾功能指标间的关系。结果：根据尿镍水平,将研究对象均分为3组（〈38、38～90和≥90μg/mol肌酐）后,尿镍水平为38～90μg/mol肌酐剂量组,血肌酐明显升高,但肾小球滤过率的估计值（eGFR）明显下降,各组间不存在线性趋势,未观察到血和尿中其他各肾功能生化指标在不同尿镍剂量组间的差异。不同尿铬剂量组间（〈38、38~88和≥88μg/mol肌酐）,血生化指标无显著改变,但尿N-乙酰-β-D-氨基葡糖苷酶（UNAG）和尿视黄醇结合蛋白（URBP）随剂量上升呈现下降趋势。各尿镍和尿铬剂量组间eGFR的异常率和各尿肾功能指标的异常率均无显著改变。结论：镍铬合金烤瓷冠配戴者尿中镍和铬的排泄水平与机体肾损伤无关。PURPOSE： To explore whether the renal function parameters were associated with urinary nickel （Ni） and chromium （Cr） in patients undergoing dental restoration of nickel-chromium （Ni-Cr）. METHODS： Seven hundred and ninety-five Ni-Cr alloy consumers were investigated by the questionnaire and the biological examination of renal function. The correlations between renal function parameters and urinary Ni （or Cr） were determined by Student＇s t test, one-way ANOVA, and Logistic regression analysis using SPSS12.0 software package. RESULTS： After dividing all subjects into three groups with equal sample size by urinary Ni （〈38,38-90, ≥90μg/mol crea.）, the middle group （38-90μg/mol crea.） had a significantly higher serum creatinine and estimated glomerular filtration rate （eGFR） compared to the other two groups, and there was no significant difference in other serum or urinary parameters of renal function. After dividing all subjects into three groups by urinary Cr（〈38,38-88, and ≥90μg/mol crea.）, no change was found in serum parameters, but urinary N-acetyl-β-D-glucosaminidase （UNAG） and retinol-binding protein （URBP） showed negative association with urinary Cr. The prevalence of either abnormal eGFR and abnormal urine parameters of renal function did not show significant change between different dose of urinary Ni or Cr. CONCLUSIONS： No association of renal changes with urinary excretion of Ni and Cr was found in patients undergoing dental restoration of Ni-Cr alloy.

关 键 词：镍铬合金烤瓷冠 肾功能损伤 尿镍 尿铬 横断面研究 

分 类 号：R783.3[医药卫生—口腔医学]