尿镉与尿锌及腰椎骨质增生相关性分析

Correlation analysis between urinary cadmium,urinary zinc and lumbar vertebra osteo-proliferation

目的探讨人尿镉(urinary cadmium,UCd)、血镉(blood cadminm,BCd)、尿锌(urinary zinc,UZn)水平与腰椎骨质增生的相关性。方法以生产原料含0.1‰Cd的某Zn粉加工厂93人为接Cd组,以该厂不接触Cd的36名员工为对照组,对两组人员进行UCd、BCd、UZn、尿β2-微球蛋白(urinaryβ2-microgloblin,Uβ2-MG)、X射线腰椎片等检查,分析各指标间的相互关系。结果接触组UCd、BCd、UZn平均值分别为(4.08±2.87)μg/gCr、(6.92±5.55)μg/L、(0.40±0.26)μg/gCr,高于对照组,差异有统计学意义(P<0.01或P<0.05);UCd超标、BCd超标、腰椎骨质增生检出率随年龄增长而升高,差异有统计学意义(P<0.01或P<0.05);UCd超标、腰椎骨质增生检出率随工龄增长而升高,差异有统计学意义(P<0.05);UCd超标组腰椎骨质增生检出率(68.0%)高于UCd正常组,差异有统计学意义(P<0.01);UCd几何值(SUCd)与腰椎骨质增生存在相关性(r=0.439);SUCd、BCd与UZn水平存在相关性(r=0.705、0.273),差异有统计学意义(P<0.01);SUCd与BCd水平有相关性(r=0.398),差异有统计学意义(P<0.01)。结论Cd可引起UCd、BCd增高、腰椎骨质增生,对年龄>40岁、工龄>10a的工人危害较大,Zn可拮抗Cd的肾脏毒性,但对骨质增生无影响。

Objective To investigate the relationship between the levels of urinary cadmium （UCd）, urinary zinc（UZn）, blood cadmium（BCd）, and lumbar vertebra osteo-proliferation. Methods Workers from a plant which produces zinc powder using raw material containing 0.1%0 Cd were investigated. 93 workers exposed to 0.1~0 Cd were taken as the experimental group, while 36 workers unexposed to 0.1~0 Cd were taken as the control group. Their UCd, UZn, BCd, urinary β2-microglobulin（Uβ2-MG） were determined,and their X-ray films of lumbar vertebra were taken. The relationships between various indicators were analyzed. Results In the exposed group, the average UCd, BCd, and UZn were （4.08 ± 2.87）μg/g Cr, （6.92± 5.55）μg/L, and （0.40±0.26） μg/g respectively, which were all higher than those of the control group, the differences were statistically significant（P〈0.01 or P〈0.05）. When UCd and BCd exceeded the normal, the positive rate of lumbar vertebra osteo-proliferation increased with the age, the difference was statistically significant（P〈0.01 or P〈0.05）. When UCd exceeded the normal, the positive rate of lumbar vertebra osteo-proliferation increased with the length of service, the difference was statistically significant （P 〈0.05）. The positive rate of lumbar vertebra osteo-proliferation of UCd exceeded group（68.0%）was higher than that of UCd normal group; the difference was statistically significant （P〈0.01）. There was a positive relationship between the SUCd and lumbar vertebra osteo-proliferation （r = 0. 439）. There was a positive relationship between UCd, BCd and UZn levels （r = 0. 705 and 0. 273）, the difference was statistically significant（P%0.01）. There was a positive relationship between the UCd and BCd levels（r= 0. 398）, the difference was statistically significant（P〈0.01）. Conclusions Cd can cause increased levels of UCd and BCd, inducing higher incidence of lumbar vertebra osteo-proliferation, which is greatly harmful to those over 40 years old in age, and those over 9 years in lengths of service. Zn might antagonize the renal toxicity of Cd; however, it has no effect on osteo-proliferation.