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目的分析手传振动作业人群周围血可溶性细胞间黏附分子(sICAM-1)水平与手传振动接触水平和手部末梢循环血管损伤程度之间的关系。方法 以广东某运动器材厂的77名手传振动作业工人为接振组,以80名健康男性作为对照组,对研究对象进行问卷调查,用酶联免疫吸附法检测血浆中sICAM-1水平;对接振组进行冷水复温试验(CWLT),并对其工作场所手传振动接触水平进行检测以计算累积振动暴露量(CVEL)。结果 接振组sICAM-1水平中位数(M)为323.2(135.2～739.4)μg/L,超过正常参考值上限211.0μg/L者(异常)占85.7%,对照组sICAM-1水平M为105.1(91.3～131.9)μg/L,均在正常参考值范围内;接振组sICAM-1水平、异常率均高于对照组,差异均有统计学意义(P<0.001)。控制吸烟、饮酒和年龄等混杂因素后,CVEL、CWLT异常和主诉振动性白指等因素与sICAM-1水平之间无关联(P>0.05)。结论 手传振动作业人群sICAM-1水平升高;sICAM-1可能参与了振动性血管损伤的发病机制,可作为手传振动健康损害效应的监测指标;但sICAM-1水平与手传振动接触水平及手部末梢血管损伤程度的相关关系有待进一步研究。
Objective To analyze the relationship between the levels of soluble intercellular adhesion molecule (sICAM-1) and the level of hand vibration transmission and the level of circulating blood vessel damage in the hands of hand vibration patients. Methods Totally 77 hand-vibration workers in a sports equipment factory in Guangdong were used as vibration-inducing group and 80 healthy men as control group. The subjects were investigated by questionnaire and the level of sICAM-1 in plasma was detected by enzyme-linked immunosorbent assay The vibration group was subjected to a cold water rewarming test (CWLT), and the hand vibration transmission contact level in the workplace was measured to calculate the cumulative vibrational exposure (CVEL). Results The median sICAM-1 level (M) was 323.2 (135.2-739.4) μg / L in the vibration receiving group, 85.7% (abnormal) in the upper limit of normal reference value of 211.0 μg / L, and the level of sICAM-1 in the control group was 105.1 (91.3 ~ 131.9) μg / L, all within the normal reference range; the amplitude and abnormal rate of sICAM-1 in the vibration group were significantly higher than those in the control group (P <0.001). There was no correlation between the levels of sICAM-1 and other factors such as CVEL, CWLT anomaly and the dominant whiteness index after controlling for smoking, alcohol consumption and age (P> 0.05). Conclusion sICAM-1 levels are increased in hand-vibration patients; sICAM-1 may be involved in the pathogenesis of vascu- lar vascular injury, which may be used as a monitoring index for the health damage effects of hand-transmitted vibration; however, the level of sICAM- And the degree of hand-tip vascular injury remains to be further studied.