本文選題：環(huán)境鎘污染 + 鎘暴露　； 參考：《中國疾病預(yù)防控制中心》2012年碩士論文

【摘要】：[目的] 了解環(huán)境鎘污染區(qū)人群的鎘暴露水平及人群腎損害情況,觀察不同鎘暴露水平下人群的腎損傷的變化情況,即探索不同環(huán)境鎘暴露水平下人群的尿鎘水平以及尿NAG、尿β2-M等健康效應(yīng)指標(biāo)的消長規(guī)律與變化幅度。 [方法] 本論文所用的膳食調(diào)查數(shù)據(jù)與人群健康調(diào)查數(shù)據(jù)均來源于中國疾病預(yù)防控制中心環(huán)境所于2010年完成的《貴州赫章鎘污染區(qū)環(huán)境鎘污染及人群健康狀況調(diào)查報(bào)告》,該項(xiàng)目已經(jīng)通過環(huán)保部驗(yàn)收。 通過對環(huán)境鎘污染區(qū)201戶546人的連續(xù)三日膳食調(diào)查獲得當(dāng)?shù)厝巳旱纳攀硵?shù)據(jù),結(jié)合當(dāng)?shù)刂饕r(nóng)作物樣品中的鎘含量,估算出人群的膳食鎘暴露水平,以此來衡量人群的環(huán)境鎘暴露水平；并在污染區(qū)與對照區(qū)開展人群的健康損害情況調(diào)查,收集調(diào)查對象的尿樣(污染區(qū)948份,對照區(qū)403份),通過檢測尿樣中尿鎘、尿NAG、尿β2-M等指標(biāo)以了解人群的腎功能狀況。然后將人群環(huán)境鎘暴露水平與尿鎘及腎損傷指標(biāo)對應(yīng)起來進(jìn)行研究,觀察在不同鎘暴露水平下人群的尿鎘及腎損傷指標(biāo)的變化情況。 農(nóng)作物樣本鎘含量采用石墨原子吸收法檢測；尿鎘采用等離子發(fā)射光譜-質(zhì)譜法(ICP-MS)檢測；尿NAG采用分光光度計(jì)比色法檢測；尿β2-M采用放射免疫分析法檢測；尿肌酐采用堿性苦味酸測定法檢測。 [結(jié)果] 1)污染區(qū)人群鎘累積攝入量的均值為1735.20mg,明顯高于對照區(qū)鎘累積攝入量456.64mmg；而兩區(qū)人群間尿鎘及腎損傷指標(biāo)值的分析結(jié)果為污染區(qū)的尿鎘值顯著高于對照區(qū)值(P0.01),而對照區(qū)的尿NAG要高于污染區(qū)(P0.01),尿β2-M兩區(qū)間未見差異(P0.05)。 2)將污染區(qū)人群按照鎘累積攝入量不同劃分為5個(gè)鎘累積攝入組,根據(jù)分組數(shù)據(jù)統(tǒng)計(jì)分析發(fā)現(xiàn)：同等鎘攝入水平下,人群各尿鎘及腎損傷指標(biāo)值的性別差異不大；而且人群的尿鎘、尿β2-M指標(biāo)值的年齡差異也不大(P0.05),但是人群尿NAG水平卻有隨年齡增長的而上升的趨勢(P0.05) 3)鎘累積攝入量分組數(shù)據(jù)分析結(jié)果表明：污染區(qū)人群的尿鎘水平隨鎘累積攝入量的增長而升高(P0.05),且尿鎘的這種變化趨勢與性別、年齡因素?zé)o關(guān)；而尿NAG、β2-M卻未呈現(xiàn)出類似的趨勢；尿鎘分組數(shù)據(jù)分析結(jié)果表明：污染區(qū)人群的尿NAG、β2-M隨尿鎘的增長而升高(P0.05),且這種變化趨勢與性別、年齡因素?zé)o關(guān)。 4)分別以鎘累積攝入水平與村別(污染區(qū)各村的鎘暴露水平不同)為分組依據(jù),進(jìn)行鎘累積攝入量與尿鎘及腎損傷指標(biāo)的曲線回歸分析。結(jié)果發(fā)現(xiàn)：各鎘累積攝入組、各村別的尿鎘值與鎘累積攝入量的關(guān)系均呈“S”曲線上升模式；而尿NAG、β2-M與鎘累積攝入量的關(guān)系未呈現(xiàn)出類似趨勢。 5)單因素卡方分析與多因素Logistic回歸分析結(jié)果表明：鎘累積攝入量為污染區(qū)人群的尿鎘、尿β2-M異常率的影響因素(P0.05),即隨著鎘累積攝入量的增加,污染區(qū)人群的尿鎘、尿β2-M的發(fā)生異常的風(fēng)險(xiǎn)會(huì)升高。 [結(jié)論] 1)污染區(qū)人群終生鎘累積攝入量(75歲)男性為2286.9mg,女性為2015.0mg,剛剛超過WHO建議的健康效應(yīng)暴露閾值2000mg,而且相比于國內(nèi)其它鎘污染區(qū)的情況,赫章的鎘污染情況不是很嚴(yán)重。 2)在當(dāng)前的環(huán)境鎘暴露水平下,作為體內(nèi)鎘負(fù)荷指標(biāo)的尿鎘隨著鎘累積攝入量的增多而升高的趨勢已經(jīng)顯現(xiàn),但是當(dāng)?shù)氐逆k暴露人群并未出現(xiàn)明顯的腎損傷情況。
[Abstract]:[Objective]
To investigate the level of cadmium exposure and renal damage in the population of environmental cadmium polluted areas, and to observe the changes of renal damage in the crowd at different levels of cadmium exposure, that is to explore the level of urine cadmium in the crowd at different levels of cadmium exposure and the law and change range of the index of the health effect of urine NAG, urine beta 2-M and so on.
[method]
The data of dietary survey and population health survey used in this paper were derived from the report on the environmental cadmium pollution and the health status of the population in the cadmium polluted area of Hezhang, Guizhou, which was completed in 2010 by the environment of China Center for Disease Control and prevention. The project has been accepted by the Ministry of environmental protection.
In order to measure the level of dietary cadmium exposure in the population, the level of cadmium exposure in the population was estimated through the dietary data of 546 people from 201 households in the environmental cadmium polluted area and the dietary data of the local population, combined with the cadmium content in the local major crop samples. The urine samples (948 polluted areas and 403 control areas) were collected to investigate the renal function of the urine samples, such as urine, cadmium, urine NAG, and urine beta 2-M, and then the cadmium exposure level of the crowd was corresponded with the urine cadmium and kidney damage indexes to observe the urine cadmium and kidney damage at different levels of cadmium exposure. The change of the injury index.
The content of cadmium in crop samples was detected by graphite atomic absorption spectrometry; urine cadmium was detected by plasma emission spectrometry (ICP-MS); urine NAG was detected by spectrophotometer colorimetry; urine beta 2-M was detected by radioimmunoassay; urine creatinine was detected by alkaline picric acid assay.
[results]
1) the average cadmium intake of the population in the polluted area was 1735.20mg, which was significantly higher than the cadmium accumulated intake of 456.64mmg in the control area, while the results of urinary cadmium and kidney damage in the two areas were significantly higher than those of the control area (P0.01), while the urine NAG in the control area was higher than that in the polluted area (P0.01), and the interval of urinary beta 2-M two was not poor. Difference (P0.05).
2) the population of the polluted area was divided into 5 cadmium accumulative intake groups according to the difference of cadmium accumulation intake. According to the statistical analysis of the group data, it was found that the sex difference of urine cadmium and kidney damage index of the crowd was not significant, and the age difference of urine cadmium and urine beta 2-M index of the crowd was not significant (P0.05), but the population urine NAG water But there is an upward trend in age (P0.05).
3) the analysis of cadmium cumulative intake group data showed that the urine cadmium level in the polluted area increased with the increase of the cumulative intake of cadmium (P0.05), and the trend of urine cadmium was not related to sex and age, while urine NAG, beta 2-M did not show a similar trend; urine cadmium group data analysis showed that the urine of contaminated area population was urine. NAG and 2-M increased with the increase of urinary cadmium (P0.05), and this trend was independent of sex and age.
4) on the basis of the cumulative intake of cadmium and the villages in the village (the levels of cadmium exposure in the villages of the polluted areas) as the basis, the cumulative intake of cadmium and urine cadmium and kidney damage indexes were analyzed. The results showed that the relationship between the cadmium accumulated intake of each village and the cumulative intake of cadmium in each village was on the "S" curve. The relationship between NAG, beta 2-M and cumulative intake of cadmium did not show a similar trend.
5) single factor chi square analysis and multiple factor Logistic regression analysis showed that the cumulative intake of cadmium was the influence factor (P0.05) of urinary cadmium and urinary beta 2-M (P0.05), that is, the risk of urinary cadmium and urinary beta 2-M increased with the increase of cumulative cadmium intake.
[Conclusion]
1) the lifetime cadmium intake (75 years old) of the population in the polluted area was 2286.9mg and the female was 2015.0mg. The exposure threshold of the health effect recommended by WHO was 2000mg, and the cadmium pollution in Hezhang was not very serious compared to the other cadmium contaminated areas in China.
2) in the current environmental cadmium exposure level, the trend of cadmium in urine as a indicator of cadmium load in the body increases with the increase of cumulative cadmium intake, but there is no obvious renal damage in the local cadmium exposed population.
【學(xué)位授予單位】：中國疾病預(yù)防控制中心
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R114

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