环境镉接触人群停止接触后肾损害预后研究  

Prognosis of Renal Dysfunction of General Population after Removal from Cadmium Exposure

作　　者：吴训伟[1] 金泰廙[1] 叶葶葶[2] 孔庆瑚 汪再娟 

机构地区：[1]复旦大学公共卫生学院劳动卫生教研室,200032 [2]复旦大学公共卫生学院预防医学教研室 [3]浙江省医科院环境医学研究所

出　　处：《中国公共卫生》2001年第10期881-883,共3页Chinese Journal of Public Health

摘　　要：目的　研究环境镉接触人群肾损害在其停止接触后的预后情况。方法　分别于 1995年和 1998年对我国某镉污染区人群停止接触前后肾功能情况进行随访调查 ,总随访人数为148名。分析其停止接触镉前后人群尿镉、尿 β2 -微球蛋白和尿白蛋白的变化情况。结果　停止接触前不同尿镉水平其停止接触后肾功能的改变不一样 ,1995年尿镉水平低者 ,肾功能损害可以恢复 ,而 1995年尿镉水平高者 ,其肾功能损害则不可逆 ;1995年和 1998年尿 β2 -微球蛋白和尿白蛋白实际水平变化 :1995年尿镉小于 5 μg/ g肌酐者 ,尿β2 -微球蛋白和尿白蛋白平均水平 1998年比 1995年明显下降 ,而尿镉大于 10 μg/g肌酐的人群 ,尿 β2 -微球蛋白和尿白蛋白平均水平在 1998年则有明显升高 (P <0 0 5 ) ;进一步分析尿镉与 β2 -微球蛋白和尿白蛋白剂量效应关系也表明 :镉接触水平低所造成的肾脏损害在停止接触后是可以恢复的 ,如接触水平高或造成的肾损害严重者 ,则损害可能是不可逆甚至恶化。结论　环境镉接触停止后肾损害的预后与停止前镉接触的水平有关。Objective To investigate the prognosis of renal dysfunction of general population removal cadmium exposure.Methods One hundred and fourty eight residents who lived in cadmium-exposed area was followed up for three years after exposure removal.Urinary cadmium,β\-2-microglobulin and albumin were analyzed in 1995 and 1998,respectively.Results The changes of renal dysfunction of residents after removal from exposure depend on the levels of urinary cadmium before exposure stopping. The renal dysfunction of residents with initial low-level urinary cadmium would be reversible, but it would be irreversible or aggravated for residents with high-level urinary cadmium. There was significant decreased excretion of urinary β\-2-microglobulin and albumin of residents,whose urinary cadmium concentration was lower than 5 μg/g creatinine in 1995 and 1998.However,there was a significant increased excretion of urinary β\-2-microglobulin and albumin of those residents with initial urinary cadmium higher than 10 μg/g creatinine.The study of dose-effect relationship between urinary cadmium and urinary β\-2-microglobulin and albumin also showed that the renal dysfunction induced by cadmium might be reversible if urinary cadmium concentration was low level before exposure stopped,or it might be irreversible or aggravated.Conclusion The prognosis of renal dysfunction of general population to cadmium related to the intensity of cadmium exposure before cadmium exposure stopping.

关 键 词：镉 环境接触 肾损害 预后 毒物 

分 类 号：X503.1[环境科学与工程—环境工程] R995[医药卫生—毒理学]