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目的探究地方性砷中毒与肝肾功能损伤关系。方法选取我市某乡镇饮水含砷量为0.02~0.77mg/L的2个病村常住人口为调查对象,参考地方性砷中毒相关诊断标准,将调查对象分为砷中毒(研究)组与非病例(对照)组,采集其尿样及血样。以血清丙氨酸氨基转移酶水平评估患者肝功能情况,应用酶联免疫法测定血清丙氨酸氨基转移酶水平;以尿微量白蛋白及尿N-乙酰-β-D-氨基葡萄糖苷酶水平评估患者肾功能,以尿微量白蛋白测定方法作为终点法;尿N-乙酰-β-D-氨基葡萄糖苷酶采用速率法测定。结果本组共调查648人,其中研究组141例,对照组507例,砷中毒检出率为21.76%;研究组肝功能异常率为10.64%,对照组肝功能异常率为5.41%,研究组肝功能异常率明显高于对照组,差异有统计学意义(P<0.05);研究组与对照组尿微量白蛋白几何均数分别为2.30mg/g Cr、2.15mg/g Cr,两组相比,差异无统计学意义(P>0.05);研究组与对照组尿N-乙酰-β-D-氨基葡萄糖苷酶几何均数分别为2.45U/g Cr、2.21U/g Cr,两组相比,差异有统计学意义(P<0.05)。结论地方性砷中毒与肝肾功能损伤有联系,同时尿N-乙酰-β-D-氨基葡萄糖苷酶可作为砷中毒造成肾脏损伤的早期重要指标。
Objective To explore the relationship between endemic arsenism and impaired liver and kidney function. Methods The resident population in two villages with arsenic content of 0.02-0.77mg / L in a drinking water in a township of our city was selected as the investigation object. According to the diagnostic criteria of endemic arsenism, the subjects were divided into arsenic poisoning (research) group and non- Case (control) group, collecting its urine samples and blood samples. Serum alanine aminotransferase levels in patients with assessment of liver function, the application of enzyme-linked immunosorbent assay serum alanine aminotransferase levels; urinary microalbuminuria and urine N-acetyl-β-D-glucosaminidase levels Renal function was assessed in patients with urinary albumin as the endpoint method; urinary N-acetyl-β-D-glucosaminidase rate method. Results A total of 648 people were investigated in this study, including 141 cases in the study group, 507 cases in the control group and 21.76% in the control group. The abnormal liver function rate in the study group was 10.64% and that in the control group was 5.41% The abnormal liver function rate was significantly higher than the control group, the difference was statistically significant (P <0.05); the geometric mean of urinary albumin in study group and control group were 2.30mg / g Cr, 2.15mg / g Cr, (P> 0.05). The geometric mean of urinary N-acetyl-β-D-glucosaminidase in study group and control group were 2.45U / g Cr and 2.21U / g Cr, respectively Compared with the difference was statistically significant (P <0.05). Conclusions There is a relationship between endemic arsenism and impaired liver and kidney function. Meanwhile, urine N-acetyl-β-D-glucosaminidase can be used as an early indicator of kidney damage caused by arsenic poisoning.