【作者】 郭智勇；

【导师】 朱启星； 杨永坚； 胡传来；

【作者基本信息】 安徽医科大学 ， 劳动卫生与环境卫生学， 2001， 硕士

【摘要】 目的 研究铝氟联合暴露的电解铝工人脂质过氧化水平与抗氧化酶活性的改变，探讨电解铝作业的职业性损伤机理，观察电解铝工人神经行为功能的改变及其与铝、氟的接触水平-效应关系，以寻找电解铝工人的早期健康监护的生物监测指标。方法 选取某铝厂电解车间工人72人和对照工人78人，测定血浆铝和尿铝浓度、血浆氟和尿氟浓度；分析血浆中谷胱甘肽过氧化物酶（GSH-Px）活性、丙二醛（MDA）含量及全血超氧化物歧化酶（SOD）活性变化情况；测定血浆中铜、锌浓度；常规方法检查血液学指标。测定全血乙酰胆碱酯酶（AchE）活性，用WHO推荐的神经行为功能测试组合（NCTB）对工人进行测试。对结果进行相应的统计分析。结果 与对照组比较，暴露组血浆铝和尿铝浓度、血浆氟和尿氟浓度均显著增高；血浆GSH-Px活性降低，血浆MDA含量增高，全血SOD活性增高；血浆铜浓度升高，血浆锌浓度降低；电解铝工人全血AchE活性降低（P值均小于0.001）；除视觉保留外，暴露组NCTB的各项测试得分均显著低于对照组，提示其在情感状态、注意力、听记忆、运动敏捷度与准确性方面有显著改变。经统计分析：血浆铝、血浆氟浓度均与血浆GSH-Px活性呈负相关，与血浆MDA含量及全血SOD活性呈正相关；且血浆氟浓度与AchE活性、数字跨度、提转敏捷度及情感状态得分间均存在显著相关。结论 电解铝工人在骨相改变之前已出现脂质过氧化水平升高，微量元素铜锌代谢异常；血浆MDA含量显著增高，GSH-Px活性显著降低，且与血浆铝、氟浓度间存在显著相关。电解铝工人有神经行为功能改变；血浆氟浓度与神经行为功能间存在一定接触水平-效应关系；多因素分析表明：在神经毒性方面，氟可能为电解铝作业的主要职业有害因素，其可能的机制是：氟致脂质过氧化反应增强，并抑制AchE活性，而导致神经行为功能改变。血浆MDA含量、GSH-Px活性、NCTB可成为电解铝工人健康监护的早期敏感的生物监测指标。更多还原

【Abstract】 Objective To investigate the occupational injury mechanism of electrolyzing-aluminum workers exposed to both aluminum and fluoride by studying changes of lipid peroxidation level and its anti-oxidase activity. Observing change of neurobehavioral function in them and the exposure-effect relationship. Searching for sensitive indices of biological surveillance in electrolyzing-aluminum workers by research above. Methods 72 workers from electrolyzing-aluminum workshop were selected as exposed group and78 healthy workers as control group. Following items were determined correctly:plasma and urine aluminum concentration, plasma and urine fluoride concentration, plasma Glutathione peroxidase(GSH-Px) activity, plasma Malonyl dialdehyde (MDA) content, whole blood Superoxide dismutase(SOD) activity, plasma cuprum and zincum concentration. Haematological items were routinely measured. Acetamide choline esterase(AchE) activity was detected too. Neurobehavioral Core Test Battery(NCTB) recommended by WHO was used for them. The results were analyzed statistically. Results As compared with the control group, the exposed group had plasma and urine aluminum concentration increased, plasma and urine fluoride concentration increased, plasma GSH-Px activity reduced, plasma MDA content increased and whole blood SOD activity increased, plasma cuprum concentration increased and zincum concentration reduced significantly, whole blood AchE activity reduced(P<O.OO1). There was significant difference of NCTB scores between exposed and control group except Benton visual retention. It suggested that central nervous system function should be affected due to occupational exposure. Statistic analysis showed that both plasma aluminum concentration and plasma fluoride concentration correlated inversely with plasma GSH-Px activity, and correlated with plasma MDA content and whole bloodSOD activity. Plasma fluoride concentration correlated with AchE activity~. scores of digit span Santa Ana and Profile of Mood States. Conclusion Occupational exposure led to lipid peroxidation level of electrolyzing-aluminum workers rised before change of skeleton occurred. Metabolism of cuprum and zincum was abnormal. MDA content increased and GSH-Px activity reduced significently and both of them correlated with plasma auminum and fluoride concentration. Occupational exposure interfered with normal neurobehavioral function of electrolyzing-aluminum workers. The exposureeffect relationship between plasma fluoride concentration and NCTB scores existed. In neural toxicity, fluoride was maybe the main occupational hazard factor. The mechanism perhaps was that change of neurobehavioral function was induced because the lipid peroxidation reaction was intensified and AchE activity was inhabited by fluoride. Plasma MDA content ~. GSH-Px activity NCTB could be chosen as the effective and sensitive indices of biological surveillance for electrolyzing-aluminum workers?health.更多还原