镉致作业工人肾功能损害可逆性研究初探  

Study on the Reversibility of Renal Dysfunction in Workers Exposed to Cadmium

作　　者：吴训伟[1] 金泰廙[1] 黄波[1] 周袁芬[1] 

机构地区：[1]复旦大学公共卫生学院劳动卫生教研室,上海200032

出　　处：《劳动医学》2001年第2期84-86,共3页

摘　　要：[目的 ]观察接受依地酸二钠 (EDTA)治疗慢性镉接触工人尿镉和肾功能改变 ,以探讨镉接触致肾损害的可逆性。 [方法 ]收集 1986年以来某冶炼厂接受EDTA治疗的 17名镉接触工人 (其中男 14名 ,女 3名 )每年治疗前后尿镉和尿 β2 微球蛋白 (β2 MG)的记录 ,分析其变化的情况。 [结果 ]尿 β2 MG一直异常 (≥ 0 8mg/g·Cr)或由正常转为异常的工人 ,尿镉平均水平基本高于 10 μg/g·Cr ,治疗期间尿 β2 MG一直正常或出现异常又转为正常的工人 ,尿镉平均水平在 10μg/g·Cr以下 ;整个治疗过程中 ,不论尿镉升高或降低 ,尿 β2 MG异常率均有所上升 ;随着镉接触终止时间的延长 ,尿 β2 MG没有下降 ;尿镉水平低于 10 μg/gCr ,肾损害可以恢复 ,反之 ,则不可逆。[结论 ]尿镉的水平是影响镉接触工人肾功能变化的主要因素 ,EDTA对镉接触工人肾功能损害没有明显疗效。Objective] This study was to explore the reversibility of renal dysfunction induced by cadmium in workers. [Methods] The changes of urinary cadmium (UCd) and renal dysfunction in cadmium exposed workers treated by ethylenediaminetetracetic acid (EDTA) promoting excretion of cadmium in urine were observed. From 1986,the annual records of UCd and β 2 microglobulin (β 2 MG) of pre and post treatment of EDTA were collected from 17 workers (male:14,female:3) in this study. [Results] It is shown that levels of urinary cadmium in workers,whose urinary β 2 MG excretion was always abnormal (≥0 8 mg/g Cr) or became abnormal during the treatment period,were above 10 μg/gCr basically. Conversely,UCd concentration was below 10 μg/gCr in those workers whose urinary β 2 MG excretion was always normal (<0 8 mg/gCr) or became normal during this treatment period. The prevalence of renal dysfunction increased regardless of UCd increasing or not,and didn’t decreased with the increasing of the time of removal from cadmium exposure. The renal dysfunction will be reversible if UCd<10 μg/gCr,or be irreversible when UCd>10 μg/gCr. [Conclusion] The level of urinary cadmium is a major factor,which affects the change of renal dysfunction caused by cadmium in workers,and no significant curative effect of EDTA treatment on renal dysfunction resulted from cadmium exposure was found.

关 键 词：镉 职业接触 肾功能 可逆性 EDTA 

分 类 号：R135.1[医药卫生—劳动卫生]