[目的 ]通过对环境镉接触人群的流行病学调查 ,探讨和评价环境镉接触和所致人体健康不良效应间的剂量 效应关系。 [方法 ]选择居住在污染区 3 5年以上并以当地自产米为主食的居民为调查对象 ,通过问卷和体检收集其既往接触史及健康状况 ,同时采集血、尿等样本 ,以尿镉、血镉和估计镉摄入量作为镉接触生物标志物 ;以尿 β2 微球蛋白、视黄醇结合蛋白、NAG酶和白蛋白 (肾损害 )、骨密度 (骨损害 )和性激素及前列腺特异抗原 (男性生殖系统损害 )为损害效应生物标志物。 [结果 ]不同污染地区调查对象的体内镉负荷与环境镉污染程度呈正相关 ,且各地区间调查对象尿镉水平差异具有显著性 (P <0 0 1)。值得注意的是 ,不同性别之间的尿镉水平存在明显的差别 ,女性高于男性。对照组尿镉均低于 5 μg/L ,低接触组大多小于 5 μg/L ,但高接触组大多大于 5 μg/L ,而且大多数尿镉异常增高者也在该组中。高污染区居民尿中 β2 微球蛋白、视黄醇结合蛋白、NAG酶和白蛋白水平均显著高于对照区 ,且与镉接触 (尿镉 )有着明显的剂量 效应关系。研究同时提示镉引起肾脏损害的广泛程度与镉接触的水平有关 :低剂量时仅累及 1～ 2个肾小管效应生物标志物变化 ,而高剂量时则引起 2个以上肾小管效应生物标志物的变化。同时也 [Objective] The purpose of this study was to investigate and evaluate the dose-response relationship between cadmium exposure and adverse effects of human health through environmental epidemiological survey of cadmium exposed to environmental cadmium. [Methods] The residents who lived in the contaminated area for more than 35 years and took the local self-produced rice as the staple food were selected as the survey subjects. Their past contact history and health status were collected through questionnaire and physical examination. Blood, urine and other samples were collected at the same time. , Blood cadmium and estimated cadmium intake as cadmium exposure biomarkers; urinary β2 microglobulin, retinol binding protein, NAG enzyme and albumin (renal damage), bone mineral density (bone damage) and sex hormones and prostate specific Antigen (male reproductive system damage) is an effect biomarker. [Results] There was a positive correlation between the cadmium load in vivo and cadmium pollution in different polluted areas, and the difference of urinary cadmium level among all the surveyed areas was significant (P <0.01). It is worth noting that there is a clear difference in urinary cadmium levels between different sexes, with women being higher than men. Urinary cadmium in the control group was less than 5 μg / L, mostly less than 5 μg / L in the low-exposure group, and mostly more than 5 μg / L in the high-exposure group, with most of the abnormal urinary cadmium concentrations also in the control group. The urinary β2-microglobulin, retinol binding protein, NAG enzyme and albumin levels of residents in high-pollution areas were significantly higher than those in the control area, and had significant dose-response relationship with cadmium exposure (urine cadmium). The study also suggested that the extensive extent of cadmium-induced kidney damage was related to the level of cadmium exposure: only 1 to 2 renal tubular biomarkers were implicated in the low doses, whereas 2 to more renal tubular effects biomarkers were reported at high doses Variety. Meanwhile also