手传振动工人累积暴露量及末梢血管损伤程度与血浆TGF-β水平的相关研究  

Investigation on correlations among plasma transforming growth factor-β level and hand transmitted vibration dose or vascular impairment degree

作　　者：李宏玲[1] 陈青松[1] 肖斌[1] 郎丽[1] 林瀚生 王海兰[1] 杨爱初[1] 

机构地区：[1]广东省职业病防治院,广东广州510310

出　　处：《中国工业医学杂志》2014年第6期406-409,413,共5页Chinese Journal of Industrial Medicine

基　　金：国家自然科学基金资助项目(81202183);广东省医学科学技术研究基金项目(B2011019)

摘　　要：目的探讨手传振动暴露职业人群血浆中转化生长因子（TGF-β）水平与手传振动接触水平、手部末梢循环血管损伤程度之间的关系。方法选取77名某金属制品厂的手传振动作业工人为振动暴露组,以30名健康男性作为对照组,现场检测手传振动接触水平并计算累积振动暴露剂量（CVEL）,采用问卷调查了解研究对象的一般情况和手臂症状,采集抗凝血用酶联免疫吸附法检测血浆中TGF-β水平;振动暴露组进行冷水复温试验（CWLT）检测,记录是否出现振动性白指（VWF）。结果作业场所的CVEL为7.4-15.7（13.2±1.3）m^2/s^4,92.2%的振动暴露工人自诉有各种手臂症状;对照组的TGF-β水平中位数（M）为341.49（151.29-1040.41）ng/L,均在正常参考值范围;振动暴露组的TGF-β水平为1519.27（610.18-5417.46）ng/L高于对照组,差异具有统计学意义（P〈0.001）。校正吸烟、饮酒和年龄等混杂因素后,TGF-β水平与CVEL高水平组和有VWF症状相关（P〈0.05）,CVEL高水平组的OR值及95%CI为15.33（1.06,221.89）,有VWF亚组的OR值及95%CI为4.55（1.05,19.78）。结论接触手传振动可导致暴露人群TGF-β水平升高,TGF-β水平升高与手传振动的暴露剂量及手部末梢血管损伤程度明显相关。Objective To study the association among plasma transforming growth factor-β （TGF-β） level, hand-arm transmitted vibration dose, and peripheral vascular impairment degree. Methods Seventy-seven workers exposed to hand-arm vibration and 30 health males were selected as exposure group and control group respectively. Measure the practical vibration level of the exposed workers and calculated the accumulative vibration exposure level （CVEL）. Exposed workers were interviewed to get their healthy status, body mass index, upper limb symptoms and occupational history etc. All the objects were taken blood samples, measure the plasma level of TGF-β with enzyme-linked immunosorbent assay, and the cool water loading test were also measured for finding vibration-induced white finger （VWF）. Results The results showed that the accumulative average vibration level （CAVL） was 7.4 - 15.7 （ 13.2 ±1.3） m^2/s^4 , 92. 2% of vibration exposed workers complained upper limb symptoms. The TGF-β level of exposure group was 1519.27 （610. 18 -5417.46） ng/L, was much higher than that of control groups [341.49 （ 151.29 - 1040. 41） ng/L, P 〈0. 001 ]. After adjusted smoking, drinking and age, the TGF-β levels were closely correlation with CVEL level and VWF incidence, their odds ratio （OR） values and 95% CI were 15. 33 （ 1.06, 221.89） and 4. 55 （1.05, 19.78） respectively. Conclusion The results suggested that the plasma level of TGF-β was related to vibration exposure level and hand peripheral vascular damage degree.

关 键 词：转化生长因子(TGF-β) 手传振动 血管损伤 

分 类 号：R135.4[医药卫生—劳动卫生]