不同原因所致慢性轻度镉中毒临床特征分析  

Analysis of clinical features of mild chronic cadmium poisoning induced by different causes

作　　者：张晓华 肖雄斌 赖燕 李颖 李莉 罗光明 黄蕾 

机构地区：[1]湖南省职业病防治院职业病科,长沙410007

出　　处：《中华劳动卫生职业病杂志》2013年第10期763-765,共3页Chinese Journal of Industrial Hygiene and Occupational Diseases

基　　金：湖南省科技厅科研项目（项目编号：2011WK3056）

摘　　要：目的 分析不同原因所致慢性轻度镉中毒的临床特征.方法 将我院2008年至2011年收治的资料齐全的90例慢性轻度镉中毒患者按中毒原因分为职业中毒组（45例）与环境污染组（45例）,分别对各组患者的临床症状、体征、实验指标及治疗效果进行分析.结果 在职业中毒组（骨痛症状）中高于环境污染组,而骨损伤影像学改变低于环境污染组,在职业中毒组（尿视黄醇结合蛋白异常率）较环境污染组明显升高,差异有统计学意义（P＜0.05）,两组间尿β-2微球蛋白、尿MA则差异无统计学意义（P＞0.05）,两组患者尿镉、尿视黄醇结合蛋白、尿β-2微球蛋白三者之间均无直线相关关系,两组患者治疗后尿镉水平变化较治疗前的差异均有统计学意义（P＜0.05）.结论 不同原因所致的慢性轻度镉中毒的临床特点有所不同,积极营养支持治疗对改善预后起到一定作用.Objective To analyze the clinical features of mild chronic cadmium poisoning induced by different causes.Methods A total of 90 patients with mild chronic cadmium poisoning,who were hospitalized in our center from 2008 to 2011 and had complete clinical data,were divided into two groups according to the causes of poisoning：environmental pollution group （n=45） and occupational poisoning group （n=45）.The clinical symptoms,signs,laboratory indices,and treatment outcomes of all patients were analyzed.Results Compared with the environmental pollution group,the occupational poisoning group had more bone pain,less bone injury （based on imaging findings）,and significantly increased abnormal rate of urinary retinol-binding protein （RBP） （P＜0.05）; there were no significant differences in urinary β-2 microglobulin （MG） and urinary microalbumin between the two groups （P＞0.05）.Urinary cadmium,urinary RBP,and urinary β-2 MG had no linear correlation between each other in the two groups.Both groups showed significant changes in urinary cadmium levels after treatment （P＜0.05）.Conclusion The clinical features of mild chronic cadmium poisoning induced by various causes are different,and active nutritional support therapy plays a positive role in improving prognosis.

关 键 词：镉中毒 特征分析 尿视黄醇结合蛋白 尿β-2微球蛋白 

分 类 号：R135[医药卫生—劳动卫生]