【摘要】 目的研究砷接触人群肾功能损害情况,探讨镉在砷接触人群肾功能损害方面与砷的联合作用。方法以贵州省地方病办公室1991年3月确诊并经1997年3月和2001年3月临床复查的122例砷中毒患者为本次调查对象,无砷污染区居民123名作为对照。以尿砷、尿镉作为接触标志物,尿β2微球蛋白(Uβ2MG)、尿白蛋白、尿N乙酰βD氨基葡萄糖苷酶(UNAG)作为砷、镉致肾小管和肾小球损害的效应标志物。同时分别计算尿砷、尿镉的基准剂量(BMD)及其下限值(BMDL)。结果接触组的接触指标和效应指标均高于对照组,尿砷、尿镉水平与Uβ2MG、尿白蛋白、UNAG水平间均为正相关,具有明显的剂量效应关系;砷、镉联合毒性比单独砷或镉同等剂量下的毒性更大。尿砷的BMD和BMDL值(以肌酐含量计)分别为12191～17188μg/g和10211～14444μg/g;尿镉的BMD和BMDL值(以肌酐含量计)分别为105～148μg/g和088～124μg/g。结论砷、镉联合毒性剂量明显低于单一毒性剂量,镉可能增强了砷在长期砷接触人群中对肾脏的损伤作用;运用BMD方法计算砷接触人群肾功能损伤尿砷、尿镉的BMD和BMDL值,尿砷、尿镉的BMDL值分别为以肌酐含量计10211μg/g、088μg/g。更多还原

【Abstract】 Objective To research the impairment of renal function and the combined effects of arsenic and cadmium exposure in population residing in polluted area,and to calculate the benchmark doses of urinary arsenic (UAs) and cadmium (UCd) in renal dysfunction Methods The concentrations of Uas and UCd were used as as exposure biomarker Urinary β 2 microglobulin (Uβ 2 MG), N acetyl β glucosaminidase (UNAG), and albumin were calculated as biomarkers of renal dysfunction The benchmark dose (BMD) and the lower confidence limit of the benchmark dose (BMDL) were calculated Totally 245 patients were enrolled in the study, them,of 122 were from the exposed area, and 123 from the control area Results UAs and UCd concentrations in the exposed group were shown significantly higher than those in the control group ( P <0 01) The levels of Uβ 2 MG, UNAG and urinary albumin in the exposed group were significantly higher than those of the controls ( P <0 01) There exsted positive correlation among the concentrations of UAs, UCd, Uβ 2 MG, urinary albumin and UNAG,showing a significant dose effect relationship The combination of cadmium and arsenic caused even more renal injury than by chemicals alone in a same dose The BMD/BMDL of UAs were estimated as 121 91 171 88 μg/g Cr and 102 11 144 44 μg/g Cr Of UCd ,the BMD/BMDL were 1 05 1 48 μg/g Cr and 0 88 1 24 μg/g Cr Conclusions This study indicates the combination of cadmium and arsenic might cause even more renal injury than by chemicals given alone, and cadmium might cause potential arsenic nephrotoxicity during long term coexposure to arsenic and cadmium in human beings It also suggests that UAs and UCd should be kept below 102 11 and 0 88 μg/g creatinine as to preventingrenal damage from coexposure to arsenic and cadmium The BMD method should be used in calculating the BMD of UAs and UCd on renal dysfunction更多还原