血管内皮素水平与振动性血管损伤及振动接触水平关联性研究

Correlation analysis among endothelin level,vibration vascular impairment degree and exposure level in hand-arm vibration exposure workers

目的探讨手传振动作业人群周围血中内皮素(ET)水平与手部末梢循环损伤程度和手传振动接触水平的关系。方法以广东省某运动器材厂77名手传振动作业工人为研究对象,对其工作场所手传振动接触水平进行检测以计算累积振动暴露量,以出现振动性白指(VWF)的接振工人为有VWF组,未出现VWF的接振工人为无VWF组,并检测其周围血血浆中ET水平。采用二元Logistic回归模型分析接振工人周围血中ET水平与振动接触水平及末梢血管损伤程度的关联性。结果本组工人ET水平为(47.52±4.86)μg/L;有VWF组ET水平低于无VWF组[(45.61±3.57)vs(49.95±4.95)μg/L,P<0.01]。控制吸烟、饮酒和年龄等混杂因素后,不同振动接触水平与ET水平无相关性(P>0.05),是否有VWF与ET水平分级的相关性有统计学意义(P<0.01)。结论接触振动工人周围血中ET水平与是否有VWF相关,提示ET水平可以作为VWF早期诊断和判断预后的指标。

Objective To explore whether peripheral blood endothelin levels are associated with the susceptibility of vascular damage and exposure levels in vibration exposed occupational population. Methods Seventy-seven workers exposed to vibration from a sports instruments manufacturing company in Guangdong province were selected for this study. vibration exposure levels were measured and cumulative vibration exposure level was assessed. In this case-control study,the workers with vibration-induced white finger（VWF） were selected as cases and the workers without VWF as controls. The level of endothelin in peripheral blood was detected by enzyme-linked immunoassay. The association between the level of endothelin and the susceptibility of vascular damage and vibration exposure was analyzed through binary Logistic regression.Results The endothelin level of the vibration exposed workers was（47. 52 ± 4. 86） μg /L. Endothelin level of VWF group was significantly lower than that of non-VWF group [（45. 61 ± 3. 57） vs（49. 95 ± 4. 95） μg /L,P〈0. 01]. After adjusted for age,smoking and alcohol,the lower endothelin level was significantly associated with higher possibility of VWF occurrence（P〈0. 01）,while it was not significantly associated with vibration exposed level（P〉0. 05）. Conclusion The endothelin level of vibration exposure workers was closely related VWF and Non-VWF. Results suggested peripheral blood endothelin level can be the VWF early diagnosis and prognosis biomarker in vibration exposure population.