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亚临床铅神经毒性的神经电图评估。

An electroneurographic assessment of subclinical lead neurotoxicity.

作者信息

He F S, Zhang S L, Li G, Zhang S C, Huang J X, Wu Y Q

机构信息

Institute of Occupational Medicine, Chinese Academy of Preventive Medicine, Beijing.

出版信息

Int Arch Occup Environ Health. 1988;61(1-2):141-6. doi: 10.1007/BF00381618.

Abstract

While heavy exposure to inorganic lead is capable of inducing symptomatic neuropathy in man, the subclinical neuropathy due to low levels of occupational lead exposure remains to be proved. The reported results of electroneurographic studies on lead workers, however, have been controversial. In this study, 40 lead smeltery workers and 50 non-exposed referents were investigated. The air concentrations of lead at worksites were 0.25 to 42.5 mg/m3. The geometric means of PbB, PbU and delta-ALAU in lead exposed group were 40.03 micrograms/dl, 71 micrograms/l and 4.68 mg/l respectively, which were significantly higher (P less than 0.001) than those (7.01 micrograms/dl, 6.0 micrograms/l and 1.81 mg/l respectively) in the reference group. There were no clinical symptoms or signs of nerve damage in either group. Alcoholism and diabetes were excluded in both groups. Nerve conduction velocity was measured by a DISA 1500 electromyograph in both groups. Eleven electroneurographic parameters, including motor nerve conduction velocity (MCV) and distal latency (DML) of median, ulnar and peroneal nerves as well as sensory nerve conduction velocity (SCV) and distal latency (DSL) of median, ulnar and sural nerves, showed statistically significant differences between the two groups. However, the results of electroneurographic measurements of each individual in the lead-exposed group were all within the normal range. There was no correlation between the blood-lead levels and the neurophysiological measurements except for the median MCV. No correlation was seen between the median MCV and the exposure duration.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

虽然大量接触无机铅能够在人类中诱发有症状的神经病变,但职业性低水平铅暴露所致的亚临床神经病变仍有待证实。然而,关于铅作业工人的神经电生理研究报告结果一直存在争议。在本研究中,对40名铅冶炼厂工人和50名未接触铅的对照人员进行了调查。工作场所空气中铅浓度为0.25至42.5毫克/立方米。铅暴露组的血铅(PbB)、尿铅(PbU)和δ-氨基乙酰丙酸(δ-ALAU)几何均值分别为40.03微克/分升、71微克/升和4.68毫克/升,显著高于对照组(分别为7.01微克/分升、6.0微克/升和I.81毫克/升)(P<0.001)。两组均无神经损伤的临床症状或体征。两组均排除了酗酒和糖尿病患者。两组均用DISA 1500肌电图仪测量神经传导速度。11项神经电生理参数,包括正中神经、尺神经和腓总神经的运动神经传导速度(MCV)和远端潜伏期(DML),以及正中神经、尺神经和腓肠神经的感觉神经传导速度(SCV)和远端潜伏期(DSL),两组间差异有统计学意义。然而,铅暴露组中每个个体的神经电生理测量结果均在正常范围内。除正中神经MCV外,血铅水平与神经生理学测量值之间无相关性。正中神经MCV与暴露持续时间之间无相关性。(摘要截短至250字)

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