成人铅接触的生物标志物研究进展

Review of research progress on biomarker of lead exposure in adult

通过复习国内外文献,按照铅的接触性生物标志物——血铅、骨铅、尿铅、发铅、乳铅等进行汇总分析,探讨成人铅接触的生物标志物及与健康关系的评价。结果：（1）血铅包含血液铅、血浆铅。入血液循环的铅99%以上存于红细胞中,不到1%存在于血浆中;血浆铅是反映机体近期铅暴露水平的较好指标,亦代表能进入胎盘的那部分铅,比全血铅更说明铅对胎儿的危害。此外,血铅与骨铅呈正相关。（2）尿铅浓度升高提示近期有铅接触,但尿铅波动较大,有去离子化干扰的问题,影响因素较多。血铅与尿铅的相关系数在0.284~0.850之间。（3）骨铅可以作为累积性铅接触的生物标志物,用于研究慢性铅接触与健康的关系。其监测方法为X线荧光仪（XRF）。影响骨铅转运与年龄、妊娠及哺乳、钙离子的代谢密切相关。（4）发铅是检验环境铅暴露的理想指示器,既可反映人体铅负荷状态,亦可反映环境污染状况。但发铅的正常值范围较大,目前没有统一。（5）监测母血铅和乳铅水平对预防儿童铅中毒有重要意义。乳铅的波动范围也较大。总之,较可靠铅接触的生物标志物对评价人体接触剂量、筛选高危和易感人群、铅中毒的诊断、制定治疗方案以及评估疗效有重要意义;但在评价结果时应考虑个体因素、样本类型、检测时间、检测方法和实验室条件等的影响。

Through literature review,analyze the relationship between these indices as blood lead,urine lead,bone lead,hair lead,and milk lead etc.and health to explore the reliable biomarker of lead exposure in adult.Result：（1）Blood lead（including whole blood lead,and plasma lead）.99% of blood lead stored in red blood cell less than 1% blood lead existed in plasma,but the latter is a better index of recent lead exposure and the part which could go into placenta,therefore,it could better explain the extent of injury to fetus.Additionally,blood lead（Cumulative Blood Lead Index）showed positive relationship with bone lead.（2）Urinary lead.Risen urinary lead suggests recently lead exposure,but it has larger fluctuation range,and has more influence factors such as the interference of deionization.The interrelation coefficient between blood lead and urine lead is 0.284—0.850.（3）Bone lead.Bone lead coud be used as a biomarker of accumulative lead exposure which may use for studying the relationship between chronic lead exposure and health.X-ray fluorescence analyzer（XRF）is the common method for bone lead monitoring.Bone lead transfer is closely correlated with age,pregnancy,lactation,and calcium ion metabolism.It has intimate connection with cognition,blood pressure and renal function especially on renal tubules.（4）Hair lead.Hair lead is an ideal indicator of environmental lead exposure,which either reflexes lead burden in body or environmental pollution,but it has larger fluctuation range.（5）Milk lead.It is also an important monitoring index which will be especially helpful in prevention of child lead intoxication,despite it also has larger fluctuation range.The review suggested that the reliable biomarker of lead exposure showed quite important significance in assessing individual exposure dose screening high-risk or susceptible population,diagnosing lead poisoning,establishing therapeutic protocol and evaluating curative effect etc.,and it is necessary to think over individual factor,a sample type,measure time,detecting method and laboratory condition during assessing measuring results.