【作者】 周勇；

【导师】 胡建安；

【作者基本信息】 中南大学 ， 公共卫生， 2007， 硕士

【摘要】 [目的]通过对郴州市香花岭、柿竹园、黄沙坪铅锌矿矿区铅镉砷混合接触的不同暴露人群的机体免疫状况的调查，从而揭示人体铅镉砷混合接触的负荷与某些免疫学指标之间的相关性，寻找金属毒物对机体损伤的敏感指标，并评价这些免疫学指标作为金属毒物的环境污染和对人体损害的早期检测指标的可能性。[方法]选择在香花岭、柿竹园、黄沙坪三个矿区内工作5年以上的工人、居住在矿区5年以上的居民作为研究对象，另选择距污染源较远且无水系联系，不受工业污染，而生活习惯、社会经济状况基本相同，从未接触过重金属毒物的居民作为对照。针对这三个人群进行随机抽样，得到样本。采用原子吸收分光光度计测量每一个调查对象的血液中和尿液中铅、镉、砷的含量，单向扩散法测定人体免疫球蛋白的含量，特异性单克隆抗体法测定人体外周血T淋巴细胞亚群，以及用植物血凝素(hytohemagglutin，PHA)非特异地刺激人体外周血T淋巴细胞，得到淋巴细胞转化率。比较不同人群血液中和尿液中铅、镉、砷的含量以及各种免疫学指标的差异，并分析毒物接触指标与免疫学指标的相关性。[结果]矿工组、矿区居民组和对照组人群中，血液中和尿液中的铅、镉、砷含量存在着差异，组间两两比较结果也都存在着差异，矿工组的血液中和尿液中铅、镉、砷的含量为最高，而对照组人群，血液中和尿液中这三种毒物的含量最低，并且这些差异均具有统计学意义(P＜0.001)。各项免疫指标的测量结果显示，三组人群的免疫指标都存在差异，免疫球蛋白IgG、IgA、IgM均为矿工组最低，对照组人群最高；人体外周血淋巴细胞转化率矿工组最低，对照组人群最高；人体外周血T淋巴细胞亚群CD4~+细胞百分比及其CD4~+细胞与CD8~+细胞的比值，为矿工组最低，对照组人群最高，而CD8~+细胞则是对照组人群最低，矿工组最高，都具有统计学意义(P＜0.001)。分析不同人群血液中和尿液中铅、镉、砷的含量与免疫学指标的相关性，得出矿工组、矿区居民组和对照组人群的血液中和尿液中铅、镉、砷含量与人体免疫球蛋白IgG、IgA、IgM含量、人体外周血淋巴细胞转化率、人体外周血CD4~+细胞百分比、CD4~+细胞与CD8~+细胞的比值存在负相关关系，而与人体外周血CD8~+细胞百分比为正相关关系，都具有统计学意义(P＜0.01)。[结论]①郴州市香花岭、柿竹园、黄沙坪铅锌矿矿区采矿工人和矿区居民的血和尿中铅、镉和砷含量增高，反映该人群的生产和生活环境受到该三种毒物污染，并在生产和生活环境中接触到这些金属毒物；②接触铅、镉和砷的采矿工人和居民免疫功能受到损害；③研究对象的血和尿中铅、镉和砷含量与所测的多项免疫学指标相关，通过这些指标的测定，能够早期发现铅、镉、砷混合接触对人群建康的损害，从而更有效的控制中毒引发的严重后果。更多还原

【Abstract】 [Objective] To study the effect of immunological function in the population exposed to the lead-cadmium-arsenic mixture in the lead-zinc mining area in Xiang hua-ling, Shi zhu-yuan and Huang sha-ping in the city of Chen Zhou, reveal the correlation between some immunological indices and lead-cadmium-arsenic mixture, search of the sensitive indices of the damage of the metal toxicants in the population, and appraise the possibility that these immunological indices have application in environment and diseases supervisions.[Methods] The workers which had worked above 5 years in the lead-zinc mining area in Xiang hua-ling、Shi zhu-yuan or Huang sha-ping and the inhabitants which had reside in mining area above 5 years were choosed as the research subjects, and the inhabitants which were apart far from and had no-connection by water system with the pollution source、had not endured the industrial pollutions、but had homological life habits and socioeconomic status, and had never exposed to the heavy metal toxicants were choosed as the contrast group. Research in the three population to random sampling, and get the samples.The contents of the lead、cadmium and arsenic in blood and urine in the three population were examined by atomic absorption spectrophotometric method. Serum immunoglobulin contents(IgG、IgA、IgM) were analysed with immunodiffusion method. The human body peripheral blood T lymphocyte subsets were assayed with specific monoclonal antibody method. The hytohemagglutin nonspecific were used to stimulate the human body peripheral blood T lymphocyte and obtaine the lymphocyte transformation rate. The contents of the lead、cadmium、arsenic in blood and urine, and the contents of the immunological indices were compared between the different population, and analysed the correlation between the immunological indices and the contents of the metal in human body.[Results] The contents of the lead、cadmium、arsenic in blood and urine in the miner workers、mining area-inhabitants and the contrast group were significantly different, and the pairwise comparison among groups also were significantly different. The contents of the lead、cadmium、arsenic in blood and urine in the miner workers were the highest, and the contents of the three toxicants in the contrast group were the lowest. The differences had significance in statistics (P<0.001) .The measuring result of the immunological indices revealed that all of the immunological indices were significantly different in the groups. The serum immunoglobulin contents and the lymphocyte transformation rate of the miner workers were the lowest, but those of the contrast group were the highest in the group; Human body peripheral blood T lymphocyte subsets indicated that the percentage of the CD4+ T lymphocyte and the ratio of CD4+/CD8+ T lymphocyte of the miner workers were the lowest, but those of the contrast group were the highest, and the percentage of the CD8+ T lymphocyte in the contrast group were the lowest, but that of the miner workers were the highest in the groups. The differences between the groups had significance in statistics (P<0.001) .The result of the correlation analysis of the immunological indices and the contents of the lead、cadmium、arsenic in blood and urine in different population showed that the contents of the three toxicants in blood and urine negatively correlated with the serum immunoglobulin contents, the lymphocyte transformation rate, the percentage of the CD4+ T lymphocyte and the ratio of CD4+/CD8+ T lymphocyte, but positively correlated with the percentage of the CD8+ T lymphocyte. These correlation had significance in statistics (P<0.01) .[Conclusion]①The contents of the lead、cadmium and arsenic in blood and urine of the workers which worked in the lead-zinc mining area in Xiang hua-ling、Shi zhu-yuan and Huang sha-ping in the city of Chen Zhou, and the inhabitants which resided in mining area had significant increased to compare with contrast group, and reflected that the workers and inhabitants had exposed to the three toxicants in working and life; (2) The immunologic function of the miners and mining area inhabitants had been damaged; (3) The contents of the lead、cadmium、arsenic in blood and urine in the research subjects correlated with the multiple immunological indices. So by early analyzing these immunological indices, we could detect the damage of lead-cadmium-arsenic mixture to the population exposed to them in earlier period, and more efficiently control the serious consequences caused by the metal toxicants.更多还原