【摘要】 目的探讨累积铅暴露工人δ-氨基-γ-酮戊酸脱氢酶(ALAD)基因多态性与肾损害的关系,实现通过基因型筛选铅作业易感人群。方法采用整群抽样方法抽取142名男性铅作业工人为研究对象,对每名工人进行基本信息收集和外周静脉血采集,检测血铅、血清肌酐、尿素氮、N-乙酰-β-D-氨基葡萄糖苷酶,并应用实时定量-聚合酶链反应分析ALAD基因多态性,在对累积肌酐清除率计算和累积铅暴露估计的基础上,根据基因对肾功能指标的调节作用,进行相关性分析。结果不考虑ALAD基因型,血铅和累积肌酐清除率呈正相关(P<0.05);ALAD1-2基因型,在低、高累积铅暴露时Person’s相关系数分别是0.39和-0.56(P<0.01);多因素线性回归:在高剂量累积铅暴露时,ALAD1-2基因型和累积铅暴露的交互作用与累积肌酐清除率具有相关性(P<0.01)。结论同时考虑血铅与实际铅暴露工龄(累积铅暴露)时,机体达到一定代偿负荷水平后,ALAD基因与累积铅暴露对肾功能起交互调节作用。更多还原

【Abstract】 Objective To explore the relationship of δ-aminolevulinic acid dehydratase( ALAD) polymorphism and renal damage in accumulated lead exposure workers. Methods With cluster sampling method,142 male lead exposed workers were recruited in Chengdu. Basic information were collected and peripheral vein blood was drawn from each subject. Blood lead level, serum creatinine, blood urea nitrogen( BUN) and N-acetyl-β-D-glucosaminidase( NAG) were all detected. ALAD gene were determined by real time polymerase chain reaction( RT- PCR). Based on creatinine clearance rate and accumulated lead exposure, correlation analysis was carried out in light of the moderating effect of the gene on renal function indicators. Results A positive relationship was confirmed in blood lead and accumulated creatinine clearance when ignoring the ALAD genotypes( P<0. 05). Correlation coefficients of calculated creatinine clearance were respectively- 0. 25 and-0. 56( both P<0. 01) on ALAD1-2genotype at low and high accumulated lead exposure stage. Linear regression showed that the interaction of ALAD1-2genetic polymorphism and ALE was significantly correlated with calculated creatinine clearance in high ALE stage( P< 0. 01). Conclusion ALE and ALAD genotype plays an interaction moderating effect on chronic renal dysfunction when the organism reaches to certain compensatory level.更多还原