摘要
目的研究铅对作业工人心电、血压变化的影响以及驱铅治疗对铅中毒作业工人心电和血压的逆转作用。方法选择某铅冶炼厂确诊为中毒并进行驱铅治疗的职工191例,监测治疗前后的血铅、锌卟啉(ZPP)、尿δ-氨基乙酰丙酸(δ-ALA)、粪卟啉、心电图和血压。结果不同血铅水平[(364.8±28.1)、(502.7±59.9)、(735.3±108.5)μg/L]组的铅作业人员ZPP[(15.6±10.1)、(18.9±11.7)、(26.3±13.2)μg/gHb]、δ-ALA[(15.1±10.8)、(12.9±9.2)、(20.6±13.0)mg/L]、粪卟啉水平间差异有统计学意义(P<0.01),同时收缩压[(118.3±11.8)、(122.7±15.4)、(133.1±12.5)mm Hg]和心电图异常率(50.00%、38.68%、61.64%)间差异亦有统计学意义(P<0.05);EDTA驱铅治疗可降低铅暴露对象的血铅、ZPP、δ-ALA及粪卟啉水平;EDTA治疗后,血铅400～μg/L组和>600μg/L组铅中毒患者的收缩压降低(P<0.01),血铅>600μg/L组心电图异常也明显下降(P<0.01),且高血压总患病率及心电图总异常率均有降低(P<0.01);不同疗程治疗剂量的疗效间差异无统计学意义(P>0.05)。结论铅可导致收缩压升高,且高血压患病率、心电图异常率上升,而驱铅治疗可降低收缩压、高血压患病率和心电图异常率。
Objective To study effects of lead poisoning on electrocardiogram and blood pressure in the lead exposure workers, and reverse effects of chelation therapy. Methods Diagnosed 191 lead poisoning workers were selected and gave 20% calcium disodium EDTA （EDTA） intravenous drip of lead treatment, while the blood lead, zinc porphyrin （ZPP）, 8 -ALA, coproporphyrin were detected, electrocardiogram （ECG） and blood pressure were examined before and after lead treatment. Results In the different level of blood lead workers [ （364. 8 ±28. 1 ）, （502. 7 ±59. 9）, （735.3 ± 108.5） μg/L], their contentofZPP [ （15.6±10.1）, （18.9±11.7）, （26.3±13.2）μg/gHb], 8-ALA [ （15.1±10.8）, （12.9±9.2）, （20. 6 ± 13.0） mg/L], c oproporphyrin and level of systolic pressure [ （ 118.3 ± 11.8 ）, （ 122. 7 ± 15.4）, （ 133.1 ± 12.5 ） mm Hg], and the prevalence rate of abnormal rate of ECG （50. 00%, 38.68%, 61.64% ） were obvious differences （ P 〈 0. 05） ; Chelation therapy could decreased level of blood lead, ZPP, 8 - ALA and coproporphyrin ; EDTA had the effectiveness on systolic pressure in 400 μg/L- and 〉 600 p±g/L group and abnormal rate of ECG in 〉 600 μg/L group, in addition EDTA had decreased total abnormal rate of ECG and total rate of hypertension; there was no significance difference between the different courses and doses of treatment. Conclusion Lead could increase systolic pressure, the prevalence rate of hypertension and ab- normal rate of ECG and chelation therapy EDTA had the effectiveness on both abnormal electrocardiogram and hypertension of lead poisoning workers.
出处
《中国全科医学》
CAS
CSCD
北大核心
2011年第36期4148-4150,共3页
Chinese General Practice
基金
国家自然科学基金(30960324
30762011)
上饶市科技支撑计划项目(091C0020)
关键词
血铅
心电图
血压
驱铅治疗
Blood lead
Electrocardiogram
Blood pressure
Chelation therapy
