CaNa_(2)-EDTA驱铅对职业性铅暴露肝功能的影响  

Effect of CaNa_(2)-EDTA on the liver function of workers occupationally exposed to lead

作　　者：鲁碧峰 姚勇 易桂林 LU Bi-feng;YAO Yong;YI Gui-lin(Science and Education Department,Wuhan prevenition and treatment center for occupational diseases,Hubei 430015,China)

机构地区：[1]武汉市职业病防治院科教科,湖北430015 [2]武汉科技大学职业危害识别与控制湖北省重点实验室,湖北430070

出　　处：《工业卫生与职业病》2023年第2期114-116,共3页Industrial Health and Occupational Diseases

基　　金：2020年度职业危害识别与控制湖北省重点实验室开放基金(OHIC2020Y07)。

摘　　要：目的探讨依地酸二钠钙(CaNa_(2)-EDTA)驱铅治疗对铅作业工人丙氨酸氨基转移酶(ALT)、门冬氨酸氨基转移酶(AST)、碱性磷酸酶(ALP)、γ-谷氨酰转移酶(γ-GT)4项血清酶活力的影响。方法选取既往在武汉市职业病防治院住院驱铅治疗的71例血铅≥400μg/L的铅作业工人为研究对象,收集其入院期间采用CaNa_(2)-EDTA驱铅治疗前和治疗后的血铅浓度及4项肝功能指标。采用配对t检验对71名住院驱铅工人治疗前和治疗后血铅浓度和4项血清酶的浓度进行比较,采用多元线性回归分析驱铅治疗前和治疗后血铅浓度改变量与4项血清酶改变的关联性。结果经配对t检验,采用CaNa_(2)-EDTA驱铅治疗前铅作业工人血铅浓度均值(557.66±140.41)μg/L高于驱铅治疗后血铅浓度均值(263.24±60.60)μg/L,差异有统计学意义(t=15.77,P<0.01);血清中ALP活力驱铅治疗前均值(71.99±21.46)U/L高于驱铅治疗后均值(69.38±17.78)U/L,差异有统计学意义(t=2.14,P<0.05)。经多元线性回归分析,血铅下降改变量与ALT、AST、ALP及γ-GT的变化量均无显著相关[95%CI:-28.43~522.59,P>0.05]。结论CaNa_(2)-EDTA驱铅治疗铅中毒效果明显,血清中ALP活力在驱铅治疗后降低;然而血铅下降与ALT、AST、ALP及γ-GT活力变化的关联性并不显著。Objective To explore the effects of calcium disodium edetate(CaNa_(2)-EDTA)on the liver function indexes of lead-exposed workers,including alanine aminotransferase(ALT),aspartate amino-transferase(AST),alkaline phosphate Enzyme(ALP),γ-glutamyltransferase(γ-GT).Methods A number of 71 cases of lead-exposed workers with blood lead≥400μg/L who were hospitalized in Wuhan Occupational Disease Prevention and Treatment Institute for lead-removal treatment were selectedas the research objects.The data of blood lead concentration and the levels off our serum enzyme indicators were collected from 71 cases before and after CaNa_(2)-EDTA lead-eliminating treatment.Paired t test was used to compare the difference of blood lead concentration and the levels of our serum enzyme indicators between cases before and after treatment.Multivariate linear regression was used to analyze the correlation between the changes in blood lead concentration and the changes of four serum enzymes before and after the treatment of lead removal.Results The paired t-test showed that the average blood lead concentration of lead-exposed workers(557.66±140.41)μg/L before CaNa_(2)-EDTA treatment was higher than the after treatment(263.24±60.60)μg/L,and the difference was statistically significan(t t=15.77,P<0.01).The mean value of serum ALP activity before lead-expelling treatmen(t 71.99±21.46)U/L was higher than that after lead-expelling treatmen(t 69.38±17.78)U/L,the difference was statistically significant(t=2.14,P<0.05).Multiple linear regression analysis showed that there was no significant correlation between the change in blood lead level and the changes in ALT,AST,ALP andγ-GT[95%CI:-28.43-522.59,P>0.05].Conclusions CaNa_(2)-EDTA treatment can effectively reduce the blood lead concentration of lead-exposed workers.The activity of the serum enzyme ALP decreased after the lead-removal treatment.There is no significant correlation between the change of blood lead and the changes of ALT,AST,ALP andγ-GT.

关 键 词：铅作业工人 依地酸二钠钙 丙氨酸氨基转移酶 门冬氨酸氨基转移酶 碱性磷酸酶 Γ-谷氨酰转移酶 

分 类 号：R135[医药卫生—劳动卫生]