某企业职业接触二硫化碳作业人员神经-肌电图检测情况调查及分析  

Survey and analysis of nerve-EMG detection in occupational workers exposed to carbon disulfide in an enterprise

作　　者：朱蛇锁 谢元辰 宋海燕 董秋 朱宝立[4] 张恒东[4] 丁帮梅[4] 韩磊[4] ZHU She-suo XIE Yuan-chen SONG Hal-yan DONG Qiu ZHU Bao-li ZHANG Heng-dong DING Bang-mei HAN Lei(Department of Occupational Diseases, Nanjing Nangang Hospital, Nanfing, Juangsu 210035, China)

机构地区：[1]南京南钢医院职业病科,江苏南京210035 [2]中牟县人民医院,河南中牟451450 [3]南京市职业病防治院,江苏南京210042 [4]江苏省疾病预防控制中心,江苏南京210028

出　　处：《中国临床研究》2017年第10期1419-1422,1428,共5页Chinese Journal of Clinical Research

基　　金：江苏省医学创新团队(CXTDA2017029);江苏省青年医学人才项目(QNRC2016536)

摘　　要：目的分析职业接触二硫化碳对作业人员神经-肌电图检查异常的影响,以及异常结果出现部位和类别的相关性。方法采用流行病学现况调查方法,收集2015至2016年南京市某企业职业接触二硫化碳作业人员的调查问卷及神经-肌电图(检测正中、尺、腓总、胫后等四组神经)检查资料并进行整理,分析二硫化碳对职业接触者神经-肌电图的影响因素和异常指标出现的部位、类型及其之间的关系。统计学检验水准取α=0.05,采用R×C表χ2检验分割法时,检验水准校正为α'=0.0083。结果职业接触二硫化碳作业人员出现神经-肌电图检查异常的因素中,性别、吸烟、经常饮酒与神经-肌电图检查异常未显示相关性(P均>0.05);接触年限长是影响神经-肌电图异常的危险因素(H=18.3850,P<0.01),从0至30年以上每5年为1个等级分为7组,以5年以下组为基准,其余6个组发生神经-肌电图异常的OR值分别为1.45、5.29、4.17、4.54、8.54、5.21。运动神经异常率明显高于感觉神经,运动神经潜伏期延长率明显高于波幅降低率(P均<0.01)。四组受检神经异常总体比较差异有统计学意义(P<0.01);胫后神经异常率(6.59%)分别低于正中神经(32.97%)、尺神经(41.76%)和腓总神经(28.57%)三组的异常率(P均<0.0083);正中、尺、腓总神经异常率之间两两比较均无统计学差异(P均>0.0083)。每组受检神经的左右侧异常率比较差异均无统计学意义(P均>0.05)。结论职业接触二硫化碳作业人员神经-肌电图异常的出现与接触年限有关,随着工龄的延长,异常出现的可能性增加。运动神经异常率明显高于感觉神经,胫后神经异常率最低,各组神经异常率与左右侧别未显示相关性。Objective To analyze the influence of occupational exposure to carbon disulfide on the abnormality of nerve- electromyography（EMG） of occupational population, as well as the site and category of occurrence of the abnormality. Methods According to the epidemiological current situation survey method, the questionnaire and data of nerve-EMG examination （median nerve,ulnar nerve,common peroneal nerve,posterior tibial nerve） from 2015 to 2016 in the workers exposed to carbon disulfide in an enterprise of Nanjing were collected and sorted out. The influence factors of carbon disulfide on the nerve-EMG detection results and their associations with the site and category of occurrence of the abnormality were analyzed. Statistical test level was c~ = 0.05, and it was corrected as oL＇ = 0. 0083 when using R ~ C table X2 test segmentation method. Results The abnormal nerve-EMG in workers exposed to carbon disulfide was not correlated with gender, smoking, often drinking （ all P 〉 0.05 ）. The long time of occupational exposure was the risk factor of abnormal nerve-EMG （H = 18. 3850,P 〈 0.01 ）. With each 5 years as a grade, the working years of occupational exposure were divided into 7 groups from 0 to more than 30 years. Taking the 0-5 years group as baseline,the odds ratio （OR） for the occurrence of nerve-EMG abnormalities in the other 6 groups were 1.45,5.29,4.17,4.54,8.54 and 5.21, respectively. The abnormality rate of motor nerve in nerve-EMG examination significantly increased compared with sensory nerve, and its prolongation rate of latency was significantly higher than amplitude decrease rate （ all P 〈 0.01 ）. The abnormal rate of posterior tibial nerve（6. 59% ） was significantly lower than those of median nerve （32.97%）, ulnar nerve （41.76%）, common peroneal nerve（28.57% ）（all P 〈0.0083） ,while there was no significant difference in abnormal rates of median nerve,ulnar nerve and common peroneal nerve （ all P 〉 0. 0083 ） for pairwise comparisons. Th

关 键 词：二硫化碳 神经-肌电图 职业暴露 接触年限 胫后神经 

分 类 号：R135.11[医药卫生—劳动卫生]