镉作业观察对象尿镉和肾小管损伤效应标志物6年追踪观察  

Change of urinary cadmium and renal tubular damage markers of 8 occupationally exposed-cadmium workers:A 6-year follow-up after exposure ceasing

作　　者：李芳林 李倩兰 张凝宇 李智民 吴子俊 

机构地区：[1]深圳市职业病防治院,广东深圳518020

出　　处：《职业卫生与应急救援》2017年第1期38-40,共3页Occupational Health and Emergency Rescue

基　　金：深圳市科技创新计划项目(编号:JCYJ20130401092802783);国家职业病临床重点专科建设项目(编号:WY2011873);深圳市重大职业病诊疗技术重点实验室建设项目(编号:CXB201111250112A)

摘　　要：[目的]观察职业性镉作业观察对象尿镉及肾小管损伤效应标志物水平的变化,比较脱离镉作业6年后镉作业观察对象尿肾小管损伤分子-1(KIM-1)的水平。[方法]选取8例职业性镉作业观察对象,对2009—2014年度的尿镉、尿β2-微球蛋白及尿维生素A结合蛋白(即视黄醇结合蛋白)水平进行跟踪观察。2014年用ELISA法检测观察对象及正常对照组尿肾小管损伤分子-1(KIM-1)的水平。[结果]停止镉作业后,观察组的尿镉平均水平略有下降趋势,但各年度间差异无统计学意义(P>0.05)。停止镉接触后,观察组尿β2-MG水平和尿视黄醇结合蛋白水平一直维持在正常范围。观察组各年度尿β2-MG水平、尿视黄醇结合蛋白水平差异均无统计学意义(P>0.05)。停止镉接触6年后,观察组尿KIM-1的水平(1.37±0.61)ng/mL,对照组为(0.62±0.35)ng/mL,两组差异有统计学意义(P<0.05)。[结论]镉作业观察对象脱离镉接触后,尿镉水平下降不明显,传统的肾小管功能损害标志物尿β2-MG及尿视黄醇结合蛋白水平无明显变化,但尿KIM-1仍存在异常。[Objective] To understand the change characteristics of urinary cadmium and renal tubular damage effect markers of workers occupationally exposed to high level cadmium after they stopped the exposure. [Methods] Eight occupationally exposedcadmium workers with high urinary cadmium level were followed-up for 6 years after they stopped occupational exposure to cadmium. The urinary cadmium,2 micro- globulin and retinol-binding protein levels were examined annually from 2009 to2014. The urinary KIM-1 was detected by ELISA in 2014 and the results were compared with the references. [Results] After the workers stopped occupational exposure,urinary cadmium varied and there was a trend that it decreased gradually,though the difference in each year was not statistically significant（P 〉 0.05）;the urine β2-MG and the urinary retinol binding protein were in the normal range. After the exposure ceasing for six years,the urine tubular injury molecule-1（KIM-1） level of exposedcadmium workers was（1.37 ± 0.61）ng/m L,which was significantly higher than that of the reference persons（P 〈 0.05）.[Conclusion] After exposure ceasing for six years,the urinary cadmium was still high,while urinary β2-MG and urinary retinolbinding protein levels,the traditional markers of renal tubular damage,were not significantly changed. However,the increased urinary KIM-1 indicated that the renal tubular damage of these workers still existed after the exposure ceasing for six years.

关 键 词：镉 尿Β2-微球蛋白 维生素A结合蛋白 肾小管损伤分子-1 

分 类 号：R692.6[医药卫生—泌尿科学]