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[目的 ]观察接受依地酸二钠 (EDTA)治疗慢性镉接触工人尿镉和肾功能改变 ,以探讨镉接触致肾损害的可逆性。 [方法 ]收集 1986年以来某冶炼厂接受EDTA治疗的 17名镉接触工人 (其中男 14名 ,女 3名 )每年治疗前后尿镉和尿 β2 微球蛋白 (β2 MG)的记录 ,分析其变化的情况。 [结果 ]尿 β2 MG一直异常 (≥ 0 8mg/g·Cr)或由正常转为异常的工人 ,尿镉平均水平基本高于 10 μg/g·Cr ,治疗期间尿 β2 MG一直正常或出现异常又转为正常的工人 ,尿镉平均水平在 10μg/g·Cr以下 ;整个治疗过程中 ,不论尿镉升高或降低 ,尿 β2 MG异常率均有所上升 ;随着镉接触终止时间的延长 ,尿 β2 MG没有下降 ;尿镉水平低于 10 μg/gCr ,肾损害可以恢复 ,反之 ,则不可逆。[结论 ]尿镉的水平是影响镉接触工人肾功能变化的主要因素 ,EDTA对镉接触工人肾功能损害没有明显疗效。
[Objective] To observe the changes of urinary cadmium and renal function in patients receiving chronic cadmium exposure after receiving edetate disodium (EDTA) to explore the reversibility of renal damage caused by cadmium exposure. [Method] The urinary cadmium and urinary β2 microglobulin (β2 MG) were collected from 17 cadmium exposed workers (including 14 males and 3 females) treated with EDTA in a smelter since 1986 and their changes were analyzed Case. [Results] The average urinary cadmium level was higher than 10 μg / g · Cr in patients with abnormal urinary β2 MG (≥ 0 8 mg / g · Cr) or normal to abnormal, and urinary β2 MG remained normal or abnormal during treatment The average level of urinary cadmium was below 10μg / g · Cr. During the whole course of treatment, the urinary β2-MG abnormal rate increased with the increase or decrease of urinary cadmium. With the prolongation of the termination of exposure to cadmium , Urinary β2 MG did not decline; urinary cadmium levels below 10 μg / gCr, kidney damage can be restored, on the contrary, it is irreversible. [Conclusion] The level of urinary cadmium is the main factor affecting the changes of renal function in workers exposed to cadmium. EDTA has no significant effect on the renal function impairment of workers exposed to cadmium.