噪声作业工人血清同型半胱氨酸及血脂水平研究

Investigation on the serum homocysteine and blood-lipid in workers exposed to noise

目的探讨职业性噪声接触对作业工人血清同型半胱氨酸（Hcy）及血脂水平的影响。方法采用整群抽样方法,选取山东省3家噪声作业工厂从事噪声作业的247名工人为接触组,以同厂非噪声作业的198名工人为对照组。采用循环酶法分别检测作业工人血清Hcy、甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白（HDL）和低密度脂蛋白（LDL）水平,采用多因素Logistic回归分析作业工人高Hcy血症的影响因素。结果 3家工厂工作场所噪声8 h等效声级超标率为44.4%～50.0%。接触组男、女性工人血清Hcy水平分别高于对照组同性别工人（P〈0.01）,接触组女性工人HDL水平低于对照组女性工人（P〈0.01）;2组工人血清TG、TC和LDL分别比较,差异均无统计学意义（P〉0.05）。接触组工人高Hcy血症检出率高于对照组工人（91.50%vs 56.57%,P〈0.01）。从事噪声作业和性别均是导致作业工人发生高Hcy血症的影响因素（P〈0.01）。噪声作业工人发生高Hcy血症的比值比（OR）是非噪声作业工人的2.78倍,男性工人发生高Hcy血症的OR是女性工人的6.21倍。结论职业性噪声接触可导致作业工人Hcy水平升高。

Objective To explore the effects of occupational noise exposure on the levels of serum homocysteine（ Hcy）and blood lipid in workers. Methods By cluster sampling method,247 workers from 3 noisy operational factories in Shandong Province were selected as exposure group,and 198 non-noise exposed workers from the same factories were chosen as the control group. The levels of Hcy,triglyceride（ TG）,total cholesterol（ TC）,high-density lipoprotein（ HDL） and low-density lipoprotein（ LDL） were examined using enzymatic cycling assay. The influence factors of high Hcy levels in workers were analyzed by multiple Logistic regression analysis. Results The over standard rate of 8-hour equivalent sound level in workplaces of the 3 factories was 44. 4%-50. 0%. The levels of Hcy in male and female workers of exposure group were higher than those of the same gender workers in the control group（ P〈0. 01）. The levels of HDL in female workers of exposure group were lower than those of the female workers in control group（ P〈0. 05）. There was no statistical significances in the levels of TG,TC and LDL in the control group and exposure group（ P〈0. 05）. The detection rate of high Hcy in exposure group was higher than that of the control group（ 91. 50% vs 56. 57%,P〈0. 01）.Noise exposure and gender were the independent influence factors causing high Hcy levels in workers（ P〈0. 05）. The odds ratio（ OR） of high Hcy in noise exposure workers was 2. 78 times of that of those non-exposed workers. The OR of high Hcy in male exposed workers was 6. 21 times of that of female workers. Conclusion Occupational noise exposure could lead to the increasd Hcy levels in workers.