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目的探讨锰暴露对人体血液及造血系统、心血管系统及神经系统的损害并分析尿锰作为机体损害效应标志物的意义。方法对广西靖西县12家涉锰企业职工体检结果进行分析,比较不同性别、接害工龄组神经系统、心血管系统、血液系统相关指标的差异,分析尿锰与各系统损害效应指标的相关性。结果本次调查共包含933例涉锰作业工人。男性收缩压、舒张压的异常检出率高于女性(χ2=15.26、8.63,P<0.01);女性血红蛋白含量、血小板计数及尿锰含量异常率高于男性(χ2=7.58、5.49、22.79,P<0.05或0.01);女性神经症状检出率是男性的12倍(χ2=27.15,P<0.01)。男性血小板含量异常检出率随接害工龄增加而增加(r=0.32,P<0.05);男女两性尿锰异常检出率与接害工龄均不相关(男:r=-0.24,P=0.60;女:r=0.20,P=0.80)。尿锰含量与收缩压、舒张压、白细胞计数、血红蛋白、红细胞计数、血小板均无统计学关联,不同尿锰组间神经症状检出率亦无统计学意义。结论提示锰暴露后对神经系统损害及铁代谢的影响在男女两性间可能存在差异,长期锰暴露对男性血小板计数产生影响,尿锰并不能反映体内锰的蓄积,且不能作为机体损害的效应标志物。
Objective To investigate the effects of manganese exposure on human blood, hematopoietic system, cardiovascular system and nervous system, and to analyze the significance of urinary manganese as a marker of organ damage. Methods The results of physical examination of 12 manganese-related enterprises in Jingxi County of Guangxi were analyzed. The differences of the related indexes of nervous system, cardiovascular system and hematological system were compared between different sex groups and casualty age groups. The correlation between urinary manganese and damage index of each system was analyzed Sex. Results The survey contains a total of 933 cases of workers involved in manganese. The prevalence of abnormal systolic and diastolic blood pressure was higher in males than in females (χ2 = 15.26, 8.63, P <0.01). The abnormal rates of hemoglobin, platelet count and urinary manganese in females were higher than those in females (χ2 = 7.58,5.49,22.79, P <0.05 or 0.01). The detection rate of female neurological symptoms was 12 times higher than that of men (χ2 = 27.15, P <0.01). The detection rate of anomalous platelet in men increased with the increase of the length of service (r = 0.32, P <0.05). The detection rate of abnormal urine and manganese in both men and women was not related to the length of service (M = r = -0.24, P = ; Female: r = 0.20, P = 0.80). Urine manganese content and systolic blood pressure, diastolic blood pressure, white blood cell count, hemoglobin, red blood cell count, platelet no statistical correlation between different urine manganese group neurological symptoms detection rate was not statistically significant. Conclusions The effects of Mn exposure on nervous system damage and iron metabolism may be different between men and women. Long-term manganese exposure has effects on platelet counts in men. Urinary manganese does not reflect the accumulation of manganese in the body and can not serve as a marker of the effect of organ damage Things.