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对铅暴露工人的神经生理学研究。

Neurophysiological studies on workers exposed to lead.

作者信息

Jeyaratnam J, Devathasan G, Ong C N, Phoon W O, Wong P K

出版信息

Br J Ind Med. 1985 Mar;42(3):173-7. doi: 10.1136/oem.42.3.173.

Abstract

Nerve conduction and somatosensory evoked potential studies were undertaken on 46 workers exposed to a combination of organic and inorganic lead. In addition electroencephalograms were carried out on 20 of the workers; the results were compared with those obtained for workers not exposed to lead. The workers exposed to lead had a mean blood lead concentration of 2.35 mumol/l (48.7 micrograms/100 ml), whereas the concentration for workers not exposed to lead was 0.76 mumol/l (15.8 micrograms/100 ml). The mean maximum motor conduction velocities of the median and the posterior tibial nerves were significantly lower in the workers exposed to lead than in the controls. Similarly, the distal latency for these two nerves was significantly prolonged for the workers exposed to lead. No significant differences for the two groups of workers were seen in the nerve conduction and distal latency measurements of the median (sensory) and the sural nerves. The EEG studies of the 20 workers exposed to lead showed no abnormalities. The somatosensory evoked potential of the median (sensory) and posterior tibial nerves were significantly prolonged when measured at the negative and positive deflections. The results suggest that, in addition to nerve conduction velocities, somatosensory evoked potential and distal latency are suitable measurements to detect subclinical neurological damage among workers exposed to lead. As these changes were seen at blood lead concentrations of 2.35 mumol/l (48.7 micrograms/100 ml) there may be a need for more stringent monitoring of workers exposed to lead.

摘要

对46名接触有机铅和无机铅混合物的工人进行了神经传导和体感诱发电位研究。此外,还对其中20名工人进行了脑电图检查;将结果与未接触铅的工人的结果进行了比较。接触铅的工人的平均血铅浓度为2.35μmol/l(48.7微克/100毫升),而未接触铅的工人的浓度为0.76μmol/l(15.8微克/100毫升)。接触铅的工人的正中神经和胫后神经的平均最大运动传导速度显著低于对照组。同样,接触铅的工人这两条神经的远端潜伏期也显著延长。两组工人在正中神经(感觉)和腓肠神经的神经传导和远端潜伏期测量方面没有显著差异。对20名接触铅的工人进行的脑电图研究未显示异常。在测量负向和正向偏转时,正中神经(感觉)和胫后神经的体感诱发电位显著延长。结果表明,除了神经传导速度外,体感诱发电位和远端潜伏期也是检测接触铅工人亚临床神经损伤的合适测量指标。由于在血铅浓度为2.35μmol/l(48.7微克/100毫升)时就出现了这些变化,可能需要对接触铅的工人进行更严格的监测。

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