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目的:探讨镍铬合金烤瓷冠配戴者中的尿镍和尿铬水平是否与机体的肾功能损伤有关。方法:对795例镍铬合金烤瓷冠配戴者进行烤瓷冠修复的问卷调查,尿镍、铬测定和血、尿肾功能生化指标测定,采用SPSS12.0软件包进行t检验、单因素方差分析和Logistic回归分析,探讨尿镍、铬水平与肾功能指标间的关系。结果:根据尿镍水平,将研究对象均分为3组(<38、38～90和≥90μg/mol肌酐)后,尿镍水平为38～90μg/mol肌酐剂量组,血肌酐明显升高,但肾小球滤过率的估计值(eGFR)明显下降,各组间不存在线性趋势,未观察到血和尿中其他各肾功能生化指标在不同尿镍剂量组间的差异。不同尿铬剂量组间(<38、38~88和≥88μg/mol肌酐),血生化指标无显著改变,但尿N-乙酰-β-D-氨基葡糖苷酶(UNAG)和尿视黄醇结合蛋白(URBP)随剂量上升呈现下降趋势。各尿镍和尿铬剂量组间eGFR的异常率和各尿肾功能指标的异常率均无显著改变。结论:镍铬合金烤瓷冠配戴者尿中镍和铬的排泄水平与机体肾损伤无关。
Objective: To investigate whether urinary nickel and urinary chromium levels in wearers of Ni-Cr alloy porcelain crowns are related to the impairment of renal function. Methods: Questionnaire investigation, urinary nickel, chromium determination and blood and urine renal biochemical indexes of 795 cases of Ni-Cr alloy porcelain crowns were carried out. SPSS12.0 software package was used for t-test. Single factor Analysis of variance and Logistic regression analysis, urinary nickel, chromium levels and renal function indicators. Results: According to urinary nickel levels, the study group was divided into three groups (<38,38-90 and ≥ 90μg / mol creatinine), and the urinary nickel level was 38 ~ 90μg / mol creatinine. Serum creatinine was significantly increased, However, the estimated glomerular filtration rate (eGFR) decreased significantly. There was no linear trend among the groups. No differences were found in the urinary and urinary renal and other biochemical parameters among different urinary nickel doses. There was no significant change in blood biochemical parameters between different urinary chromium doses (<38,38-88 and ≥88 μg / mol creatinine), but urinary N-acetyl-β-D-glucosaminidase (UNAG) The binding protein (URBP) showed a downward trend with dose. There was no significant change in the abnormal rate of eGFR and the abnormal rate of urinary and renal function indexes between different urinary nickel and urinary chromium dosage groups. Conclusion: The excretion of nickel and chromium in urinary nickel-chromium alloy porcelain crowns did not correlate with renal injury.