铝接触对电解工人认知功能的影响及其影响因素

Effect of aluminum exposure on cognitive function in electrolytic workers and its influential factors

目的通过现况调查阐明铝接触对电解工人认知功能的影响及其轻度认知功能障碍（MCI）的患病情况，并探讨其影响因素。方法选取某电解铝厂电解车间66名退休工人作为接触组，对照组工人来自同一地区的某面粉厂退休工人70名，采用简短精神状态量表（MMSE）筛选MCI患者；采用电感耦合等离子质谱法（ICP-MAS）测定血铝含量；应用多元统计学方法探讨MMSE得分的影响因素，血铝水平与MCI患病率的关联性。结果铝接触组工人的血铝水平（25．18±2．65）μg／L明显高于对照组（9．97±2．83）μg／L差异有统计学意义（P〈0．01）。MMSE问卷测试结果显示，铝接触组工人的总分（26．13±2．57）明显低于对照组（27．89±1．91），差异有统计学意义（P〈0．05），其中铝接触组时间和地点定向力、短时记忆、计算力及语言能力得分明显低于对照组，差异有统计学意义（P〈0．05）。铝接触组的MCI检出率（18．2％）明显高于对照组的MCI检出率（5．7％），差异有统计学意义（P〈0．01）；MMSE问卷得分的主要影响因素是性别、年龄、文化程度和血铝水平。Logistic回归分析显示MCI检出率与血铝明显正相关（OR=1．168，P〈0．01）。结论长期铝接触可引起工人的认知功能障碍，可能是MCI发病的危险因素之一；高龄、男性和文化水平低、血铝水平高可能是认知功能障碍的危险因素。

Objective To clarify the effect of aluminum exposure on the cognitive function in elec- trolytic workers and the prevalence of mild cognitive impairment （MCI） among them by prevalence survey, and to investigate its influential factors. Methods Sixty-six retired workers from the electrolysis workshop of an electrolytic aluminum plant were selected as an aluminum exposure group, while 70 retired workers from a flour mill in the same region were selected as a control group. MCI patients were screened out by Mini-Mental State Examination （MMSE）; the blood aluminum level was measured by inductively coupled plasma-mass spectrom- etry; multivariate statistical analysis was used to investigate the influential factors for MMSE scores and the cor- relation between blood aluminum level and MCI prevalence. Results The aluminum exposure group showed a significantly higher blood aluminum level than the control group （25.18±2.65 μg/L vs 9.97±2.83 μg/L, P〈0.01 ）. The total MMSE score of the aluminum exposure group （26.13±2.57） was significantly lower than that of the control group （27.89±1.91） （P〈0.05）, particularly the scores on time and place orientation, short-term memory, calculation ability, and language skill （P〈0.05）. The detection rate of MCI was significantly higher in the alu- minum exposure group （18.2%） than in the control group （5.7%） （P〈0.01）. The main influential factors for MMSE scores were gender, age, education level, and blood aluminum level. The logistic regression analysis indi- cated that the MCI prevalence was significantly correlated with blood aluminum level in the study population （OR=1.168, P〈0.01）. Conclusion Long-term exposure to aluminum can cause cognitive disorders in elec- trolytic workers and may be one of the risk factors for MCI. Advanced age, male, low education level, and high blood aluminum level may be high-risk factors for cognitive impairment.