长期接触铅作业工人肾功能损害探讨

The Kidney Damage Effect of Long Term Exposure to Lead in Workers

［目的］探讨长期接触铅作业工人肾功能损害。［方法］选择三组接触铅作业工人（第一组为长期接铅仍在岗位的工人；第二组为长期接铅但已脱离岗位退休的工人；第三组为短期接铅的工人）和对照组同样测定血铅（Ｂ－Ｐｂ）、尿β２ －微球蛋白（Ｕ－β２－ＭＧ）、尿δ－氨基酮戊酸（Ｕ－δ－ＡＬＡ）内生肌酐清除率（ＣＣｒ）等指标。［结果］三组接铅工人的血铅浓度平均值均与对照组之间存在明显差异，第一组工人的Ｕ－β２－ＭＧ和Ｕ－δ－ＡＬＡ 浓度最高并与其他各组之间有显著性差异，而第二组与第三组此两项指标与对照组之间没有显著性差异。临床体检各组人员中均未发现有异常症状和体征。［结论］长期接触铅作业工人肾功能将受到损害，但早期的肾功能损害是可恢复的，Ｕ－β２ －ＭＧ作为肾小球早期损害指标是较为敏感的，建议将其作为接铅工人肾损控制的监护指标。

Objective]To study the kidney damage effect of long term exposure to lead in workers.[Methods]Three groups of workers exposed to lead (1 st long term lead exposure workers;2 nd long term lead exposure retired workers;3 rd short term lead exposure workers) were compared with corresponding control group.The concentration of lead in blood (B Pb)and urine,β 2 microglobulin (U β 2 MG),δ aminolevulinic acid (U δ ALA) and clearance rate of creatine (CCr) in urine ect.were determined.[Results]The average B Pb concentrations in the three lead exposure groups were significantly higher than that in the control group.The highest concentrations of U β 2 MG,U δ ALA and CCr were found in 1 st group and significantly different from other groups,but not in 2 nd and 3 rd group.No clinical signs of renal impairment were found among all workers.[Conclusions]Long term lead exposure can cause kidney damage,and early kidney damage is revessible.U β 2 MG as a sensitive indicator of early kidney tubular damage is suggested as a biomarker for kidney demage in occupational lead exposure workers.