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目的了解苯乙烯对职业接触人员心血管造成的损伤及其生物监测指标。方法选择苯乙烯接触人员108名和对照人员115名,检测血脂水平[总胆固醇(CHO)、三酰甘油(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)]、一氧化氮(NO)、心肌肌钙蛋白Ⅰ(cTnⅠ)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、天冬氨酸转氨酶(AST)等心血管损伤指标并进行比较,对苯乙烯职业接触人员的观察指标和个体接触累计剂量、工龄等职业因素进行相关分析。结果苯乙烯接触组的TG水平高于对照组(P<0.05),而其HDL和血中NO水平均低于对照组(P<0.05)。未发现2组心肌损伤指标水平差异有统计学意义(P>0.05)。接触组的HDL降低百分率高于对照组(P<0.05),其余各指标异常百分率与对照组比较差异无统计学意义(P>0.05)。TG水平与工作场所平均浓度×工龄呈正相关,HDL水平与个人接触剂量、工作场所平均浓度和工作场所平均浓度×工龄呈负相关,NO水平与个人接触累计剂量和工作场所平均浓度×工龄呈负相关(P<0.05),接触组各心肌损伤指标与个体接触剂量等因素无相关性(P<0.05)。结论苯乙烯可能对接触人员的心血管有一定损伤作用,有必要对职业接触人员开展相应的生物监测。
Objective To understand the cardiovascular damage caused by styrene to occupational exposure and its biological monitoring indicators. Methods One hundred and eighty-eight styrene exposure workers and 115 control workers were enrolled in this study. Serum lipids (CHO, TG, HDL, LDL), nitric oxide (NO), cardiac troponin Ⅰ (cTnⅠ), creatine kinase CK (CK-MB), lactate dehydrogenase (LDH) and aspartate aminotransferase (AST) The occupational exposure to styrene occupational exposure indicators and individual exposure to cumulative doses, length of service and other occupational factors were analyzed. Results Compared with the control group, the TG level in the styrene exposure group was significantly lower than that in the control group (P <0.05), while the levels of HDL and NO in the blood were lower than those in the control group (P <0.05). There was no significant difference between the two groups in myocardial injury index (P> 0.05). The percentage of HDL decreased in the exposure group was higher than that in the control group (P <0.05). There was no significant difference between the other groups (P> 0.05). The level of TG was positively correlated with the average working age × length of service. The level of HDL was negatively correlated with the personal exposure dose, the average concentration in the workplace and the average concentration in the workplace × length of service, and the cumulative level of NO and personal exposure and the average concentration in the workplace × length of service (P <0.05). There was no correlation between each myocardial injury index and individual exposure dose (P <0.05). CONCLUSIONS Styrene may have some damage to the cardiovascular system of exposed workers. It is necessary to conduct corresponding biological monitoring of occupational exposure personnel.