慢性铅接触者肾损害早期监测指标的研究

Early Monitoring Indices for Renal Injury in People Chronically Exposed to Lead

[目的]估算引起肾功能损害的血铅的基准剂量 (BMD)和基准剂量可信区间下限 (LBMD) ,探索铅接触引起肾损害的生物接触限值。[方法]选择某蓄电池厂的工人135名为铅接触组 ,以机械工人和学生为对照。观察了血铅含量与尿总蛋白 (TP)、尿β2_微球蛋白 ( β2_MG)和尿N_乙酰_β_D_氨基葡萄糖苷酶 (NAG)的关系。用BMDSVersion1.3.1软件的logis tic模型进行基准剂量估算。[结果]引起肾损害的血铅BMD和LBMD分别为299.4～588.7μg/L和253.4～402.3μg/L,引起肾损害血铅LBMD大小依次为TP、β2_MG和NAG。[结论]尿NAG是监测肾功能损害最敏感的指标 。

To estimate benchmark dose(BMD)and the lower confidence limit on the benchmark dose(LBMD)of blood lead(Pb),and explore the biologic exposure limits of lead that may result in renal dysfunction.135workers from one storage battery plant were selected as Pb exposure group while143mechanics and students as the control group.The relationships beˉtween blood Pb content and the urinary excretion of total protein(TP),β 2 _microglubin(β 2 _MG)and N_acetyl_β_ D_glucosamindase(NAG)were observed.The quantal linear logistic regression model in BMDS Version1.3.1was used to calculate BMD and LBMD of blood Pb.The BMD and LBMD of blood Pb for kidney injury indices were from299.4to588.7and from253.4to402.3μg/L,respecˉtively.The LBMD of blood Pb for kidney injury indices was ranged fromhigh to lowas TP,β 2 _MG and NAG.[Conclusion]The urinary NAG activity could be as a sensitive index for monitoring early renal injury.In assessing renal function in workers occupationally exposed to Pb,blood Pb level from250to400μg/L is a warning signal.