锰作业工人血液生化和免疫指标改变的探讨

Discussion on changes of biochemical and immunological indexes in workers exposed to manganese

目的探讨锰中毒的早期诊断指标。方法选择2011年某集装箱企业锰电焊作业工人96人作为暴露组,暴露组又按接触猛的剂量不同分为低、中、高接触组,分别为29、25和42人;再根据尿中锰含量分为低锰和高锰吸收组,分别为56和40人。以空气中锰为接触指标、尿锰为吸收指标。另选食品加工企业86人作为对照组,对2组进行肝功能、血清中免疫球蛋白和T淋巴细胞亚群含量检测。结果尿中锰含量与年龄、性别、接触工龄均无相关关系(P>0.05);不同接触组中尿锰分级构成差异亦无统计学意义(χ2=3.663,P>0.05);中、高接触组、高吸收组丙氨酸转氨酶(ALT)活力和麝香草酚浊度试验(TTT)结果明显高于对照组,差异有统计学意义(P<0.05);中、高接触组、高吸收组胆碱酯酶(ChE)活力明显低于对照组,差异有统计学意义(P<0.05);高接触组IgG含量明显高于对照组和低接触组,差异有统计学意义(P<0.05);高吸收组IgA、IgM含量明显高于对照组和低吸收组,差异有统计学意义(P<0.05);接触组和高吸收组CD4、CD45百分含量明显低于对照组,差异有统计学意义(P<0.05);接触组CD4/CD8比值明显低于对照组,差异有统计学意义(P<0.05)。结论锰能导致肝功能异常和机体免疫功能下降。肝和免疫功能指标可作为锰中毒的早期检测指标。

[ Objective] To study the early diagnostic indexes of manganese poisoning. [ Methods] 96 workers exposed to manganese were collected from a container enterprise in 2011, and the exposure group was divided into the low, middle and high exposure groups according to the exposure dose, which included 29, 25 and 42 workers respectively. Meanwhile, the exposure group was di- vided into the low and high manganese absorption groups according to the urine manganese value, which included 56 and 40 workers respectively. The manganese level in air was regarded as the exposure index, and the urine manganese value was used as the ab- sorption index. 86 workers from food processing enterprise were the control group. The liver function, serum immunoglobulin con- tent and T lymphocyte subsets content of workers in two groups were detected. [ Results ] The urine manganese value had no correla- tion with age, sex and exposure time （ P 〉 0.05 ） , and there was no significant different in constitution of urine manganese grades between different exposure groups （ x2 = 3. 663, P 〉 0.05 }. Alanine transaminase （ ALT） activities and thymol turbidity test （TTT） results of middle exposure group, high exposure group and high absorption group were significantly higher than those of the control group （ P 〈 0.05 }. Cholinesterase （ChE） activity of middle exposure group, high exposure group and high absorption group was significantly lower than that of the control group （ P 〈 0.05 ）. IgG content of high exposure group was significantly higher than that of the control group and low exposure group （ P 〈 0.05 ）. IgA and IgM contents of high absorption group were significantly higher than those of the control group and low absorption group [ P 〈 0.05 ）. The percentage contents of CIM and CIM5 in exposure groups and high absorption group were significantly lower than those in the control group （ P 〈 0.05）. The CD4/CD8 ratio of expo- sure groups was significantly lower than that of the control group （ P 〈 0.05 ）. [ Conclusion ] Manganese may cause abnormal liver function and lower immune function. Liver function and immune function can be used as the early detection indexes of manganese poisoning.