三甲基氯化锡作业工人生物学监测指标的研究

Biological monitoring of workers exposed to trimethyltin chloride

目的 探讨职业接触三甲基氯化锡（TMT-cl）作业工人的生物学监测指标。方法利用气相色谱分析法，对发生TMT-cl中毒的5个企业接触TMT-cl的44名男性作业工人（接触组）和某食品厂50名工人（对照组）尿中TMT-cl水平和血清钾含量进行测定，并对使用的甲基硫醇锡热稳定剂或造粒料、废料中TMT-cl含量进行分析。结果重、中、轻度TMT-cl中毒患者尿中均检出TMT-cl，分别为（0．869±0．392）、（0．963±0．482）、（0．716±0．384）μg／L，与对照组比较，差异有统计学意义（P〈0．01），尿中TMT-cl与病情严重程度无明显的平行关系（F=1．88，P〉0．05）；TMT-cl重度中毒者第4天尿中TMT-cl与第1天比较，差异无统计学意义（P〉0．05），而中、轻度TMT-cl中毒者第4天尿中TMT-cl与第1天比较明显下降，差异有统计学意义（P〈0．01）；第21天，重、中、轻TMT-cl中毒者尿中TMT-cl明显高于接触反应组，差异有统计学意义（P〈0．01）。接触组低血钾发生率77.3％，明显高于对照组，差异有统计学意义（P〈0．01）；接触组平均血钾水平低于正常参考值（3．5mmol／L），与对照组比较，差异有统计学意义（P〈0．01），且血钾水平与病情严重程度存在平行关系（F=4.45，P〈0．05）。接触组尿中TMT-cl与血钾呈负相关（r=0．4456，P〈0．01）。结论尿中TMT-cl可作为TMT-cl中毒特异性接触指标；血钾可作为早期的生物监测指标，以发现早期中毒人群。

Objective To investigate suitable biomarkers for workers exposure to trimethyhin chloride （TMT-cl）. Methods Urinary samples of 44 male workers from five TMT-cl occupational poisoning incidents were collected. Methyhin mereaptide stabilizers and waste plastics used in the incidents were also collected. The levels of TMT-cl in all the samples were determined by gas chromatography. The concentration of blood potas- sium for each poisonings was determined compared to control group （50 male workers of a food company） , and the correlation between blood potassium and urinary TMT-cl were also determined. Results TMT-cl was detected in urine of all the poisonings.The results were （0.869±0.392）μg/L （severe poisoning）, （0.963±4）.482） μg/L （moderate poisoning）, （0.716±0.384） μg/L （mild poisoning） respectively and the difference was statistically significant （P〈0.01） . But the severity of the clinical status did not seem to be closely correlated to the level of urinary TMT-cl （F=1.88, P〉0.05）. In the severe poisonings, there were no differences in urinary TMT- cl on day 4 after poisoning from day 1 （P〉0.05） . In contrast, urinary TMT-cl was decreased significantly on day 4 than on day 1 in mild and moderate poisonings （P〈0.01）.On day 21, levels of urinary TMT-cl of all the poisonings were higher than those of the workers exposed to TMT-cl who had no clinical status （P〈0.01）. Blood potassium levels of exposed group was 77.3% which was significantly lower than normal value （P〈0.01） . The concentration of blood potassium was lower than normal value （3.5 mmol/L） and was correlated with the severity of the clinical status （F=4.45, P〈0.05） . Level of urinary TMT-cl of exposed group was negatively correlated with blood potassium （r=-0.4456, P〈0.01）. Conclusion Level of urinary TMT-cl can be used as exposure biomarker of TMT-cl poisoning. Blood potassium is an early biomarker of effect for TMT-cl poisoning so as to find poisoning population early.