低水平职业性铅接触人群血清铜相关蛋白与神经行为功能变化关系  

The relationship between copper-related protein and neurobehavioral function in individuals with occupational exposure to low-level lead

作　　者：王俊锋 王丽媛 朱毅 王唯承 何滨 王伟轩 郑刚 张艳淑 WANG Jun-feng;WANG Li-yuan;ZHU Yi;WANG Wei-cheng;HE Bin;WANG Wei-xuan;ZHENG Gang;ZHANG Yan-shu(School of Public Health,North China University of Science and Technology,Tcingshan,Hebei 063000,China;不详)

机构地区：[1]华北理工大学公共卫生学院,河北唐山063000 [2]华北理工大学附属医院,河北唐山063000 [3]华北理工大学实验动物中心,河北唐山063000 [4]空军军医大学军事预防医学系,陕西西安710032

出　　处：《中国职业医学》2021年第4期366-372,共7页China Occupational Medicine

基　　金：国家自然基金面上项目(82073598);河北省自然基金面上项目(H2020209250);唐山市科学技术研究与发展计划(19130214g)。

摘　　要：目的分析低水平职业性铅接触人群的神经行为功能与血清中铜相关蛋白谷胱甘肽硫转移酶M1(GSTM1)、缺氧诱导因子1α亚基(HIF1α)、环氧化酶1(COX1)、金属硫蛋白(MT)水平的相关性,筛选职业性铅接触所致神经行为改变的生物标志物。方法采用判断抽样方法,选择某蓄电池厂194名职业性铅接触工人为铅接触组,以同厂120名无职业性铅接触的工人为对照组。采用电感耦合等离子体-质谱法测定2组人群血铅水平,《心境状态量表》(POMS)调查其情感状况,中文版第三版多媒体神经行为测试评价系统(NES-C3)测试学习记忆力和心理活动相关指标的神经行为能力指数(NAI),酶联免疫吸附试验检测血清中铜相关蛋白水平。采用主成分分析进行情感状态、学习记忆力和心理活动主成分提取后,以多重线性回归分析神经行为功能指标的影响因素。结果与对照组比较,铅接触组人群血铅水平偏高[(57.15±11.12)vs(177.86±80.04)μg/L,P<0.01],头晕、记忆力下降、睡眠障碍、疲乏无力、四肢出冷汗、四肢发冷、四肢发麻、四肢远端刺痛感、四肢抽搐、手握东西不稳、口腔有金属味、恶心呕吐、厌食、便秘、腹胀、腹痛、牙痛/牙齿松动等症状的检出率均升高(P值均<0.01),POMS的紧张-焦虑、忧郁-沮丧、疲劳-惰性、愤怒-敌意、困惑-迷茫维度得分均升高(P值均<0.01),有力-好动维度得分下降(P<0.01)。铅接触组人群NES-C3测试6个指标(系列加减、视觉保留、记忆扫描、听数字广度、视简单反应时、目标追踪)的NAI均低于对照组(P值均<0.01)。与对照组比较,铅接触组人群血清GSTM1和HIF1α水平均下降(P值均<0.01),COX1和MT水平均升高(P值均<0.01)。铅接触组人群血清GSTM1、HIF1α、COX1、MT分别与其情感状态、学习记忆和心理活动指标具有不同程度相关性(P值均<0.05)。多重线性回归分析结果显示,血清COX1水平是情感状态的�Objective To analyze the relationship between the neurobehavioral functions of individuals exposed to low-level lead and the levels of serum copper-related proteins glutathione S-transferase M1(GSTM1), hypoxia inducible factor-1 alpha(HIF1α), cyclooxygenase 1(COX1) and metallothionein(MT), and to screen biomarkers for changes in neurobehavioral function caused by occupational lead exposure. Methods A total of 194 workers who exposed to low-level lead(lead-exposed group) and 120 workers without lead exposure(control group) were selected from a battery factory as the research subjects by judgment sampling method. The inductively coupled plasma-mass spectrometry was used to determine blood lead levels of the two groups, and the State of Mood Scale(POMS) was investigated to assess the emotional state. The computerized neurobehavioral evaluation system in Chinese version 3(NES-C3) was used to test the neurobehavioral ability index(NAI) of related indicators of learning memory and mental activity. Enzyme-linked immunosorbent assay was used to detect the levels of copper-related protein in serum. After using principal component analysis to extract the principal components of emotional state, learning memory and mental activity, multiple linear regression was used to analyze the influencing factors of neurobehavioral function. Results The blood lead level of the lead-exposed group was increased [(57.15±11.12) vs(177.86±80.04) μg/L, P<0.01], and the incidence of symptoms such as dizziness, memory loss, sleep disturbance, fatigue, weakness, cold sweats in extremities, cold extremities, tingling of extremities, tingling sensation in the distal extremities, tetany, instability of holding things, metallic taste in the mouth, nausea and vomiting, anorexia, constipation, abdominal distension, abdominal pain, toothache/tooth loosening were increased(all P<0.01) compared with the control group. Meanwhile, the scores of tension-anxiety, depression-dejection, fatigue-inertia, anger-hostility, confusion-bewilderment of POMS were

关 键 词：铅 神经行为 情感状态 学习记忆力 心理活动 血清 蛋白 生物标志物 

分 类 号：R135.11[医药卫生—劳动卫生]