317名铅作业人员血铅水平与运动神经传导功能的关系的研究  

Relationship between blood lead level and motor nerve conduction velocity among 317 lead-exposed workers

作　　者：李刚[1] 李庆辉 孙素梅[1] 邢威[1] 傅景海[1] 王军明[1] 

机构地区：[1]辽宁省职业病防治院,沈阳110005 [2]中冶葫芦岛锌业股份公司职防所

出　　处：《中华劳动卫生职业病杂志》2014年第8期593-595,共3页Chinese Journal of Industrial Hygiene and Occupational Diseases

基　　金：卫生行业科技专项基金项目（200902006）

摘　　要：目的 探索铅作业人员神经系统早期损伤的敏感指标,为建立有效的职业健康监护路径和方案提供科学依据.方法 采用原子吸收光谱法对317名铅作业人员血铅值进行检测,血铅值范围为26.90～912.80 μg/L,根据血铅正常值（201μg/L）,可接受上限值（400 μg/L）和诊断值（600 μg/L）将接铅人员分为4个组,采用单因素方差分析对运动神经传导功能进行检查和分析.结果 正中神经各组末端潜伏期、波幅之间差异有统计学意义,其中血铅最高剂量（＞600 μg/L）组末端潜伏期均值为3.63 ms,明显长于总均值3.30 ms;波幅均值为5.63 μV,明显低于总均值7.27 μV.各组运动传导速度之间差异无统计学意义.尺神经各组波幅之间差异有统计学意义,其中血铅最高剂量组波幅为4.31 μV,明显低于总均值4.87 μV.其他参数之间无显著性差异.结论 正中神经的运动神经传导末端潜伏期和波幅指标可作为接铅作业人员神经系统早期亚临床损伤的最敏感客观指标.Objective To find a sensitive index of early injury of the nervous system in lead-exposed workers and to provide a scientific basis for establishing an efficient occupational health surveillance route.Methods A total of 317 lead-exposed workers （blood lead levels：26.90～912.80 μg/L,determined with the atomic absorption spectrum） were divided into four groups according to the normal blood lead level （201 μg/L）,acceptable upper limit of blood lead （400 μg/L）,and diagnostic value （600 μg/L）.The motor nerve conduction function was examined and analyzed by one-way ANOVA.Results The distal latency and amplitude of the median nerve were significantly different between groups.The median distal latency of the highest blood lead group （〉600 μg/L） was 3.63 ms,which was significantly longer than the average level （3.30 ms）,and the median nerve amplitude of the highest blood lead group was 5.63 μV,significantly lower than the average level （7.27 μV）.No significant difference was found between different groups in motor conduction velocity.Significant difference was found in ulnar nerve amplitude between groups.The ulnar nerve amplitude of the highest blood lead group was 4.31 μV,significantly lower than the average level （4.87 μV）.No significant differences were observed in other parameters between groups.Conclusion The distal latency and amplitude of the median nerve can be used as a sensitive index for the diagnosis of early subclinical motor nerve injury in lead-exposed workers.

关 键 词：接铅作业人员 运动神经传导功能 

分 类 号：R131[医药卫生—劳动卫生]