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[职业性接触金属汞对选定止血参数的影响]

[The effect of occupational exposure to metallic mercury on selected parameters of hemostasis].

作者信息

Nowakowska B, Prazanowski M, Palmowska M, Szymczak W

机构信息

Szpitala Klinicznego, Instytutu Medycyny Pracy, Lodzi.

出版信息

Med Pr. 1997;48(5):529-38.

PMID:9501335
Abstract

The group investigated comprised 60 workers under conditions of chronic exposure to metallic mercury vapours (mean exposure duration--9.3 yrs; mean age of subjects--38.5 yrs). The control group was composed of 24 non-exposed persons (mean age--39.9 yrs). The workers exposed were divided into three groups according to the air concentration of metallic mercury vapours at the workpost, group A--0.15-0.17 mg/m3, group B--0.03-0.08 mg/m3 and group C--0.02-0.03 mg/m3. The workers qualified for the study did not receive any medication containing acetylsalicylic acid derivatives, and did not consume alcoholic drinks for few days prior to the study. Persons with the diagnosis or the history of blood disorders, venous or arterial thrombosis as well as those with diabetes and hyperlipidaemia were excluded from the study. The haemostasis assessment was based on the results of laboratory tests, PLT, TBT, ACT, APTT, HTCT, INR and Fg, AT III, alpha 2 M, FDP, and FM concentrations. The comparison of the exposed and control groups revealed a statistically significant decrease in ACT and AT III concentrations. When particular groups under exposure were compared with one another and the controls, the increased INR and Fg concentrations were found in group A. Moreover, this group showed an increased platelet count, as well as decreased TBT and alpha 2 M concentrations. However, the differences between the groups were statistically insignificant. The results of the study indicated that chronic exposure to mercury may impair haemostasis and lead to hypercoagulability. The latter may result from the deficiency of natural coagulation inhibitors.

摘要

该研究组由60名长期接触金属汞蒸气的工人组成(平均接触时长——9.3年;研究对象平均年龄——38.5岁)。对照组由24名未接触者组成(平均年龄——39.9岁)。根据工作岗位上金属汞蒸气的空气浓度,将接触汞的工人分为三组,A组——0.15 - 0.17毫克/立方米,B组——0.03 - 0.08毫克/立方米,C组——0.02 - 0.03毫克/立方米。符合研究条件的工人在研究前未服用任何含乙酰水杨酸衍生物的药物,且在研究前几天未饮用酒精饮料。患有血液疾病、静脉或动脉血栓诊断或病史以及患有糖尿病和高脂血症的人员被排除在研究之外。止血评估基于实验室检测结果,包括血小板计数(PLT)、全血凝固时间(TBT)、活化凝血时间(ACT)、活化部分凝血活酶时间(APTT)、血细胞比容(HTCT)、国际标准化比值(INR)、纤维蛋白原(Fg)、抗凝血酶III(AT III)、α2巨球蛋白(α2M)、纤维蛋白降解产物(FDP)和纤维单体(FM)浓度。暴露组与对照组的比较显示,ACT和AT III浓度有统计学意义的降低。当将特定暴露组相互比较以及与对照组比较时,发现A组的INR和Fg浓度升高。此外,该组血小板计数增加,TBT和α2M浓度降低。然而,各组之间的差异无统计学意义。研究结果表明,长期接触汞可能会损害止血功能并导致高凝状态。后者可能是由于天然凝血抑制剂缺乏所致。

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