电焊作业工光损伤性黄斑病变的检出率及叶黄素的作用

Detected rate oflutein by phototoxic maculopathy from welding arc in occupational welders

目的 探讨电焊作业工人光损伤性黄斑病变检出率及相关影响因素。方法 对102名电焊工（204只眼）进行眼底彩色超声波检查、视野计及光学相干断层扫描检查,按照年龄、防护措施、每天工作时间和工龄分组,比较各组光损伤性黄斑病变检出情况。再将调查对象随机分为叶黄素干预组（52人）和对照组（50人）,检测2组的最佳矫正视力、黄斑色素密度、眩光及对比敏感度。结果 共检出光损伤性黄斑病变阳性65只眼（31.9%）,光损伤性黄斑病变检出率组间比较,严格专业防护组低于随意专业防护组和非专业防护组;每天工作时间≤4h组低于4～7h组,工龄≤10a组低于工龄〉10a组;差异均有统计学意义（P〈0.05）。眩光敏感度比较,叶黄素干预组在T2时高于对照组,在T3时黄斑色素密度、眩光敏感度明2.5°、眩光敏感度暗2.5°和对比敏感度暗2.5°比较,叶黄素干预组高于对照组,差异均有统计学意义（P〈0.05）。结论 光损伤性黄斑病变在电焊作业工人中有较高的检出率,每天工作时间和工龄是重要的危险因素,补充叶黄素在一定程度上可保护电焊作业工的视功能。

Objective To investigate the health impact and the influence of risk factors related to phototoxic maculopathy by welding arc in occupational welders. Methods A group of 102 male occupational welders （204 eyes）were randomly selected for the ophthalmologic examination including fundus photography, perimetry, and the high definition optical coherence tomography （OCT）scan. All the subjects were divided into groups according to. The detected rates of phototoxic maculopathy were compared among the groups by ages, protection degrees, length of service, operating time. The subjects was divided randomly into the lutein group（n= 52）and the placebo group（n= 50）for the examinations including the best visual acuity, serum lutein concentrations, macular pigmentoptical density （MPOD）, contrast and glare sensitivity. Results The total detected rate of phototoxic maculopathy was 31.90°（65 eyes）. The detected rate in the strict protection group was lower than the randomed protective group and the nonprofessional protection group , The detected rate in the group who worked for shorter than 4 hours service was lower than the 4%7 hours service group. The detected rate in the group who worked for shorter than 10 years operating time was lower than 10 years more operating time group. All the differences were statistically significant（P〈0.05）. The lutein group prior to the placebo group at glare sensitivity in T2, The lutein group prior to the placebo group in T3 at macular pigmentoptical density （MPOD）, glare sensitivity under photopic conditions 2.5%, glare sensitivity under seotopie conditions 2.5%, contrast sensitivity under seotopie conditions 2.5%. All the differences were statistically significant（P〈0.05）. Conclusions High detected rate of phototoxic maeulopathy was found in the occupational welders by welding arc. The risk factors of phototoxic maculopathy in male occupational welders are the length of service, operating time. Lutein supplementation can protect the occupational welders in a certain degree of visual function.