周围血5-羟色胺与手传振动接触水平及末梢血管损伤的相关性  

Correlation of Peripheral Blood 5-Hydroxytryptamine with Hand-Arm Vibration Exposure and Peripheral Vascular Damage

作　　者：郎丽[1] 林瀚生 陈青松[1] 肖斌[1] 曾繁松[1] 

机构地区：[1]广东省职业病防治院住院部,广东广州510300

出　　处：《环境与职业医学》2016年第6期542-546,共5页Journal of Environmental and Occupational Medicine

基　　金：广东省科技计划项目(编号:2014A020212733);广东省医学科学技术研究基金项目(编号:A2014078);广东省中医药局科研项目(编号:20142004)

摘　　要：[目的]研究手传振动接触工人周围血5-羟色胺水平与振动接触水平及末梢血管损伤的相关性。[方法]选取广东某运动器材厂77名手传振动作业工人作为研究对象,对其进行问卷调查了解一般情况、手臂自觉症状、是否出现振动性白指(VWF)等;现场检测手传振动接触水平并计算累积振动暴露剂量(CVEL),采集抗凝血用酶联免疫吸附法检测血浆中5-羟色胺水平,并进行冷水复温试验(CWLT)检测。采用二分类非条件logistic回归模型分析手传振动接触工人周围血5-羟色胺水平与手传振动接触水平及末梢血管损伤的相关性。[结果]高水平手传振动接触CVEL分组5-羟色胺的水平高于低水平组(z=-2.352,P=0.034);CWLT异常组的5-羟色胺水平高于正常组(z=-3.211,P=0.001)。校正年龄、吸烟与饮酒等混杂因素,logistic回归分析发现,CVEL水平高低和CWLT是否异常与周围血5-羟色胺水平相关,CVEL高水平组的OR及95%CI为3.17(1.12,8.94),CWLT异常组为7.34(1.44,37.30);是否有VWF与周围血5-羟色胺水平不相关,OR及95%CI为1.92(0.74,5.00)。[结论]接触手传振动可导致接触人群5-羟色胺水平升高,手传振动的接触剂量及手部末梢血管损伤程度与5-羟色胺水平升高明显相关。[Objective] To explore the correlation of peripheral blood 5-hydroxytryptamine（5-HT） levels with vibration exposure levels and peripheral vascular damage in hand-arm vibration exposed workers. [Methods] Seventy-seven workers exposed to hand-arm vibration from a sports equipment manufacturing company in Guangdong were selected for this study. General information, upper limb symptoms, and vibration-induced white finger（VWF） of the workers were collected by questionnaire. Cumulative vibration exposure level（CVEL） was calculated through on-site tested hand-arm vibration levels of the selected workers. Level of 5-HT in peripheral blood was detected by enzyme-linked immunosorbent assay. Cool water loading test（CWLT） was also conducted for the workers. The association of 5-HT level with hand-arm vibration exposure level and peripheral vascular damage was analyzed using binary non-conditional logistic regression models. [Results] The high CVEL group showed a higher 5-HT level than the low CVEL group（z=-2.352, P=0.034）. The 5-HT level in the abnormal CWLT group was much higher than that in the normal CWLT group（z=-3.211, P=0.001）. After adjusted for age, smoking, and drinking, according to the logistic regression model, 5-HT level was associated with CVEL and CWLT ：ORs（95%CIs） were 3.17（1.12, 8.94） for high CVEL vs. low CVEL and 7.34（1.44, 37.30） for abnormal CWLT vs. normal CWLT. The 5-HT level was not correlated with VWF results with OR（95%CI） as 1.92（0.74, 5.00）. [Conclusion] The results suggests that hand-arm vibration exposure might result in elevated 5-HT levels, and the level of 5-HT correlates to vibration exposure level or hand peripheral vascular damage degree.

关 键 词：手传振动 5-羟色胺 末梢血管损伤 振动性白指 冷水复温试验 累积振动接触水平 

分 类 号：R135.4[医药卫生—劳动卫生]