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新入职铅作业工人的心率变异性与周围神经传导速度及血铅的关系。

Heart rate variability and peripheral nerve conduction velocity in relation to blood lead in newly hired lead workers.

机构信息

Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium.

Department of Endocrinology, Beijing Lu He Hospital and Key Laboratory of Diabetes Prevention and Research, Capital Medical University, Beijing, China.

出版信息

Occup Environ Med. 2019 Jun;76(6):382-388. doi: 10.1136/oemed-2018-105379. Epub 2019 Mar 30.

Abstract

OBJECTIVES

Previous studies relating nervous activity to blood lead (BL) levels have limited relevance, because over time environmental and occupational exposure substantially dropped. We investigated the association of heart rate variability (HRV) and median nerve conduction velocity (NCV) with BL using the baseline measurements collected in the Study for Promotion of Health in Recycling Lead (NCT02243904).

METHODS

In 328 newly hired men (mean age 28.3 years; participation rate 82.7%), we derived HRV measures (power expressed in normalised units (nu) in the high-frequency (HF) and low-frequency (LF) domains, and LF/HF) prior to long-term occupational lead exposure. Five-minute ECG recordings, obtained in the supine and standing positions, were analysed by Fourier transform or autoregressive modelling, using Cardiax software. Motor NCV was measured at the median nerve by a handheld device (Brevio Nerve Conduction Monitoring System, NeuMed, West Trenton, NJ, USA). BL was determined by inductively coupled plasma mass spectrometry.

RESULTS

Mean BL was 4.54 µg/dL (IQR 2.60-8.90 µg/dL). Mean supine and standing values of LF, HF and LF/HF were 50.5 and 21.1 nu and 2.63, and 59.7 and 10.9 nu and 6.31, respectively. Orthostatic stress decreased HF and increased LF (p<0.001). NCV averaged 3.74 m/s. Analyses across thirds of the BL distribution and multivariable-adjusted regression analyses failed to demonstrate any association of HRV or NCV with BL.

CONCLUSIONS

At the exposure levels observed in our study, autonomous nervous activity and NCV were not associated with BL.

TRIAL REGISTRATION NUMBER

NCT02243904.

摘要

目的

既往研究中神经活动与血铅(BL)水平之间的关系相关性有限,因为随着时间的推移,环境和职业暴露大大减少。我们使用在“促进回收铅健康研究”(NCT02243904)中收集的基线测量值,研究了心率变异性(HRV)和正中神经传导速度(NCV)与 BL 的关系。

方法

在 328 名新入职的男性(平均年龄 28.3 岁;参与率 82.7%)中,我们在长期职业性铅暴露之前获得了 HRV 测量值(高频(HF)和低频(LF)域以及 LF/HF 的归一化单位(nu)表示的功率)。使用 Cardiax 软件通过傅里叶变换或自回归模型分析仰卧位和站立位的 5 分钟心电图记录。使用手持式设备(美国新泽西州 West Trenton 的 NeuMed 公司的 Brevio 神经传导监测系统)测量正中神经的 NCV。通过电感耦合等离子体质谱法测定 BL。

结果

平均 BL 为 4.54μg/dL(IQR 2.60-8.90μg/dL)。平均仰卧位和站立位的 LF、HF 和 LF/HF 值分别为 50.5 和 21.1 nu 和 2.63,以及 59.7 和 10.9 nu 和 6.31。直立应激降低了 HF 并增加了 LF(p<0.001)。NCV 平均为 3.74 m/s。在 BL 分布的三分之一处进行分析和多变量调整回归分析均未能表明 HRV 或 NCV 与 BL 之间存在任何关联。

结论

在我们研究中观察到的暴露水平下,自主神经活动和 NCV 与 BL 无关。

试验注册号

NCT02243904。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8293/6585574/68c2ed663ae6/oemed-2018-105379f01.jpg

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