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目的探讨职业性慢性镉中毒常见的临床表现和诊断原则,以及工龄、尿镉与尿β2-微球蛋白、尿视黄醇结合蛋白之间的关系。方法对15例患者进行全面的临床、实验室检查,结合国家诊断标准进行职业病诊断,并对各项结果进行综合分析。结果15例患者常见的临床表现为头晕、腰酸腰痛;实验室检查连续2次尿镉超过5.00μmol/mol肌酐,尿β2-微球蛋白10.340~30.094μmol/mol肌酐,尿视黄醇结合蛋白0.680~15.596μmol/mol肌酐,其中尿β2-微球蛋白及尿视黄醇结合蛋白均升高5例,单纯尿β2-微球蛋白升高10例,无单纯尿视黄醇结合蛋白升高者,根据诊断标准均诊断为职业性慢性轻度镉中毒。结论本组病例中,工龄长短、尿镉高低与尿β2-微球蛋白、尿视黄醇结合蛋白的数值大小并未形成递进的关系。
Objective To investigate the common clinical manifestations and diagnostic criteria of occupational chronic cadmium poisoning and the relationship between length of service, urinary cadmium and urinary β2-microglobulin and urinary retinol binding protein. Methods Fifteen patients underwent comprehensive clinical and laboratory examinations, diagnosed with occupational diseases according to the national diagnostic criteria, and analyzed the results comprehensively. Results The common clinical manifestations of 15 patients were dizziness, lumbar acid and back pain. The urinary cadmium concentration exceeded 5.00 μmol / mol creatinine, the urinary β2-microglobulin 10.340 ~ 30.094 μmol / mol creatinine, urinary retinol binding protein 0.680 ~ 15.596μmol / mol creatinine, urinary β2-microglobulin and urinal retinol binding protein were elevated in 5 cases, simple urine β2-microglobulin increased in 10 cases, no simple urinary retinol binding protein According to diagnostic criteria were diagnosed as occupational chronic mild cadmium poisoning. Conclusion In this group of patients, length of service, urinary cadmium level and urinary β2-microglobulin, urinary retinol binding protein values did not form a progressive relationship.