[红细胞嘧啶5'-核苷酸酶检测用于职业性铅中毒筛查的评估]
[Assessment of erythrocyte pyrimidine 5'-nucleotidase test for screening of occupational lead poisoning].
作者信息
Lü L, Lin G, Wang Q
机构信息
Shanghai Medical University, Shanghai 200040, China.
出版信息
Zhonghua Yi Xue Za Zhi. 2000 Apr;80(4):283-6.
OBJECTIVE
To determine the diagnostic value of red cell P5'-N for detecting occupational lead poisoning.
METHODS
Red cell pyrimidine 5;-nucleotidase, blood lead and urine lead levels, free erythrocyte protoporphyrin (FEP), zinc protoporphyrin (ZPP) and urine delta-aminolevulinic acid levels were determined in 157 lead exposed workers and 30 non-exposed healthy people. According to the golden standard; i.e. blood lead >/= 1.93 micromol/L and >/= 2.90 micromol/L, the diagnostic value of red cell P5'N and other indicators for detecting blood lead >/= 1.93 micromol/L and >/= 2.90 micromol/L was compared by receiver operative characteristic curve (ROC) software. After determining the optimal cut-points of the above indicators for detecting the blood lead >/= 1.93 micromol/L and >/= 2.90 micromol/L, the sensitivity of the parallel tests for detecting the blood lead >/= 1.93 micromol/L and >/= 2.90 micromol/L was calculated and compared by EPINFOR software.
RESULTS
For detecting blood lead level >/= 1.93 micromol/L, the areas under ROC curve (AUC(ROC)) of P5'N was significantly larger than that of urinary lead and urinary delta-ALA (P < 0.05). The sensitivity of parallel tests with ZPP and P5'N was significantly larger than that of parallel tests with Upb and Udelta-ALA. For detecting blood lead level >/= 2.90 micromol/L, the areas under ROC curve (AUC(ROC))of P5'N was significantly larger than that of urinary lead, FEP and urinary delta-ALA (P < 0.05). The sensitivity of parallel tests with P5'N and ZPP was significantly larger than that of parallel tests with Upb and Udelta-ALA, and that of parallel tests with ZPP and FEP (P < 0.05).
CONCLUSION
For detecting blood lead >/= 1.93 micromol/L and >/= 2.90 micromol/L, red cell P5'N is more accurate. It is worth being applied in detecting occupational lead poisoning. For detecting blood lead >/= 1.93 micromol/L and >/= 2.90 micromol/L, the parallel tests with P5'N and ZPP are more accurate.
目的
确定红细胞P5'-N对职业性铅中毒的诊断价值。
方法
测定157名铅接触工人和30名未接触铅的健康人的红细胞嘧啶5'-核苷酸酶、血铅和尿铅水平、游离红细胞原卟啉（FEP）、锌原卟啉（ZPP）及尿δ-氨基乙酰丙酸水平。以血铅≥1.93 μmol/L和≥2.90 μmol/L为金标准，应用受试者工作特征曲线（ROC）软件比较红细胞P5'N及其他指标对血铅≥1.93 μmol/L和≥2.90 μmol/L的诊断价值。确定上述指标对血铅≥1.93 μmol/L和≥2.90 μmol/L检测的最佳切点后，应用EPINFOR软件计算并比较检测血铅≥1.93 μmol/L和≥2.90 μmol/L平行试验的灵敏度。
结果
对于血铅水平≥1.93 μmol/L的检测，P5'N的ROC曲线下面积（AUC(ROC)）显著大于尿铅和尿δ-氨基乙酰丙酸（P<0.05）。ZPP与P5'N平行试验的灵敏度显著大于尿铅与尿δ-氨基乙酰丙酸平行试验。对于血铅水平≥2.90 μmol/L的检测，P5'N的ROC曲线下面积（AUC(ROC)）显著大于尿铅、FEP和尿δ-氨基乙酰丙酸（P<0.05）。P5'N与ZPP平行试验的灵敏度显著大于尿铅与尿δ-氨基乙酰丙酸平行试验，以及ZPP与FEP平行试验（P<0.05）。
结论
对于血铅≥1.93 μmol/L和≥2.90 μmol/L的检测，红细胞P5'N更准确，值得应用于职业性铅中毒检测。对于血铅≥1.93 μmol/L和≥2.90 μmol/L的检测，P5'N与ZPP平行试验更准确。
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