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目的 研究环境镉接触人群肾损害在其停止接触后的预后情况。方法 分别于 1995年和 1998年对我国某镉污染区人群停止接触前后肾功能情况进行随访调查 ,总随访人数为148名。分析其停止接触镉前后人群尿镉、尿 β2 -微球蛋白和尿白蛋白的变化情况。结果 停止接触前不同尿镉水平其停止接触后肾功能的改变不一样 ,1995年尿镉水平低者 ,肾功能损害可以恢复 ,而 1995年尿镉水平高者 ,其肾功能损害则不可逆 ;1995年和 1998年尿 β2 -微球蛋白和尿白蛋白实际水平变化 :1995年尿镉小于 5 μg/ g肌酐者 ,尿β2 -微球蛋白和尿白蛋白平均水平 1998年比 1995年明显下降 ,而尿镉大于 10 μg/g肌酐的人群 ,尿 β2 -微球蛋白和尿白蛋白平均水平在 1998年则有明显升高 (P <0 0 5 ) ;进一步分析尿镉与 β2 -微球蛋白和尿白蛋白剂量效应关系也表明 :镉接触水平低所造成的肾脏损害在停止接触后是可以恢复的 ,如接触水平高或造成的肾损害严重者 ,则损害可能是不可逆甚至恶化。结论 环境镉接触停止后肾损害的预后与停止前镉接触的水平有关。
Objective To study the prognosis of kidney damage caused by cadmium exposed to environmental cadmium in environmental cadres. Methods The follow-up investigation of renal function before and after stopping the contact in a cadmium-contaminated area in China in 1995 and 1998 were conducted respectively, with a total of 148 follow-up visits. The changes of urinary cadmium, urinary β2 - microglobulin and urinary albumin before and after the cessation of exposure to cadmium were analyzed. Results Different levels of urinary cadmium did not change after stopping the contact before stopping the contact. In 1995, the urinary cadmium level was lower, and renal dysfunction could be recovered. In 1995, the urinary cadmium level was irreversible after renal function impairment. Changes of actual levels of urinary β2 - microglobulin and urinary albumin in 1998 and 1998: In 1995, urinary cadmium was less than 5 μg / g creatinine, urinary β2 - microglobulin and urinary albumin in 1998 than in 1995 the average level decreased significantly, However, urinary cadmium levels above 10 μg / g had a significantly higher urinary β2 - microglobulin and urinary albumin levels in 1998 (P <0.05). Further analysis of urinary cadmium and β2 - microglobulin The dose-response relationship with urinary albumin also suggests that kidney damage caused by low levels of cadmium exposure is regained after contact ceases and that damage may be irreversible or even worse if the level of exposure is high or if kidney damage is severe. Conclusion The prognosis of renal damage after cadmium exposure in the environment is related to the level of cadmium exposure before it ceased.