【摘要】：目的 探討δ-氨基乙酰丙酸脫水酶（δ-aminolevulinic acid dehydratase，ALAD）和維生素D受體（vitamin D receptor，VDR）基因多態(tài)性與漢族職業(yè)鉛暴露工人血鉛、血紅蛋白和血清鈣的關(guān)系，為定群研究提供基礎(chǔ)資料，為篩選高危人群提供科學依據(jù)。 方法 1、2011年11月對武漢市某鉛蓄電池廠鉛煙、鉛塵進行現(xiàn)場監(jiān)測，并結(jié)合該企業(yè)2006-2010年現(xiàn)場監(jiān)測資料，評估不同鉛作業(yè)位點鉛煙和鉛塵的動態(tài)變化情況。 2、對該企業(yè)職工進行問卷調(diào)查和常規(guī)職業(yè)病健康體檢。 3、根據(jù)文獻報道的ALAD和VDR不同等位基因在人群中的分布頻率，估算出最小樣本量分別為125人和222人，本次研究從參與體檢的387名工人中分別選擇了186名工人和230名工人用聚合酶鏈反應(yīng)-限制性片段長度多態(tài)性（PCR-RFLP）方法檢測了工人的ALAD和VDR基因亞型，限制性內(nèi)切酶分別為MspⅠ和BsmⅠ，火焰原子吸收光譜法測230名工人的血清鈣水平。 4、比較不同ALAD基因亞型對工人血鉛和血紅蛋白的影響以及不同VDR基因亞型工人間血鉛和血清鈣水平的差異。 5、應(yīng)用Excel錄入數(shù)據(jù)，SAS8.1進行統(tǒng)計學分析，以p=0.05作為差異是否有統(tǒng)計學意義的判斷標準。 結(jié)果 1、衛(wèi)生學調(diào)查 縱觀2006-2011年該企業(yè)的環(huán)境監(jiān)測資料，每個鉛作業(yè)位點的鉛煙、鉛塵濃度均超過國家標準的0.03mg/m~3和0.05mg/m~3，鉛煙在焊接作業(yè)位點的濃度最高且近四年來呈現(xiàn)出增高的趨勢，幾何均數(shù)為0.355mg/m~3，鉛塵在分片作業(yè)位點最高，波動幅度較大，幾何均數(shù)為1.123mg/m~3,其他作業(yè)位點鉛煙、鉛塵濃度的變化幅度不大； 焊接組工人佩戴進口3G口罩，且每班平均工作時間2小時，而其他工種工人佩戴的均為普通防塵口罩，每班工作時間均為8小時。 2、2011年不同工種工人血鉛水平比較 血鉛在不同工種工人中的分布與工人工作環(huán)境中的鉛濃度分布基本一致，分片組工人血鉛最高，為327.92μg/L，而焊接作業(yè)位點鉛煙濃度雖高，，但工人工作時間短，防護措施更為嚴密，實際接觸劑量小，工人血鉛水平并不高，為310.57μg/L，低于鉛煙濃度更低的熔鉛作業(yè)位點的工人。 3、ALAD和VDR基因頻率分布 186名檢測了ALAD基因型的工人中，ALAD11純合子基因型174人，占93.55%，ALAD_(12)雜合子基因型12人，占6.45%，未檢測到ALAD_(22)純合子基因型；對于VBR基因，VDR_(bb)純合子基因型198人，VDR_(Bb)雜合子基因型29人，VDR_(BB)純合子基因型3人，分別占86.09%，12.61%，1.30%。ALAD和VDR基因型分布均符合Hardy—Weinberg平衡。 4、ALAD不同基因亞型工人血鉛和血紅蛋白的比較 與ALAD_(11)基因型工人相比，ALAD_(12)基因型工人的血鉛濃度呈現(xiàn)出增高的趨勢，但差異無顯著統(tǒng)計學意義（P0.05），ALAD_(12)基因型工人血紅蛋白水平則顯著低于ALAD_(11)基因型工人（P0.05）。 5、VDR不同基因亞型工人血鉛和血清鈣水平的比較 攜帶有VDR_B等位基因的工人血清鈣明顯低于VDR_(bb)純合子基因型的工人（P0.05），而血鉛濃度顯著增高（P0.05）。 結(jié)論 1、該鉛蓄電池廠的鉛煙、鉛塵濃度嚴重超標，對工人的健康造成一定的威脅，雖然改善該企業(yè)工人工作環(huán)境在近幾年內(nèi)不可能實現(xiàn)，但可以通過增強個體防護措施來減少鉛煙、鉛塵對工人健康的影響。 2、ALAD和VDR基因多態(tài)性都會影響鉛毒性，ALAD_(12)基因型工人比ALAD_(11)基因型工人對鉛的血液毒性更易感，是鉛毒性的易感性人群；VDR_B等位基因也是鉛毒性的易感基因之一，該機制可能與VDR基因多態(tài)性影響鈣的代謝且鉛和鈣的代謝途徑相似有關(guān)。
[Abstract]:objective
The relationship between the polymorphism of delta aminolevulinic acid dehydratase (delta -aminolevulinic acid dehydratase, ALAD) and vitamin D receptor (vitamin D receptor, VDR) and the blood lead, hemoglobin and serum calcium of the workers exposed to lead were investigated to provide the basic data for the group study and provide a scientific basis for screening high-risk population.
Method
In November 12011, the lead smoke and lead dust in a lead storage battery factory in Wuhan were monitored. The dynamic changes of lead smoke and lead dust at different lead sites were evaluated in combination with the 2006-2010 year site monitoring data of the enterprise.
2, a questionnaire survey and routine occupational health examination were conducted.
3, according to the frequency of the distribution of ALAD and VDR alleles in the population, the minimum sample size was estimated to be 125 and 222. In this study, 186 workers and 230 workers were selected from the 387 workers participating in the physical examination, and the workers were detected by the polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) method. The ALAD and VDR gene subtypes were Msp I and Bsm I, respectively. The serum calcium level of 230 workers was measured by flame atomic absorption spectrometry.
4, to compare the effects of different ALAD gene subtypes on blood lead and hemoglobin in workers and the difference between blood lead and serum calcium levels among workers with different VDR gene subtypes.
5, Excel was used to input data, SAS8.1 was used for statistical analysis, and p=0.05 was used as a criterion for statistical difference.
Result
1, hygienic investigation
According to the environmental monitoring data of 2006-2011 years, the concentration of lead smoke in each lead site exceeded the national standard 0.03mg/m~3 and 0.05mg/m~3. The concentration of lead smoke at the welding site was highest and increased in the last four years, the geometric mean was 0.355mg/m~ 3, the lead dust was the highest in the slicing site, and the fluctuation amplitude was higher. The average geometric mean is 1.123mg/m~3, and the change of lead smoke and lead concentration is not significant.
The welding workers wear the imported 3G mask, and the average working time of each class is 2 hours, while the other workers are wearing ordinary dust mask, and the working time of each class is 8 hours.
Comparison of blood lead levels of workers of different types of work in 22011 years
The distribution of blood lead in the workers of different types of work is basically the same as the distribution of lead concentration in workers' working environment. The blood lead of the workers in the division group is the highest, which is 327.92 mu g/L, while the concentration of lead smoke in the welding site is high, but the working time of the workers is short, the protective measures are more strict, the actual amount of contact agent is small and the blood lead level of the workers is not high, which is lower than 310.57 um, lower than that of the workers. A worker with a lead site of lower lead smoke.
3, ALAD and VDR gene frequency distribution
Among the 186 workers who tested the ALAD genotypes, the ALAD11 homozygote genotypes were 174, 93.55%, and ALAD_ (12) heterozygote genotype 12, 6.45%, and no ALAD_ (22) homozygote genotypes; for the VBR gene, VDR_ (BB) homozygote genotype 198, VDR_ (Bb) heterozygote genotype 29, VDR_ (BB) homozygote 3, 86.09%, 12.61, respectively. The distribution of 1.30%.ALAD and VDR genotypes accorded with Hardy Weinberg balance.
4. Comparison of blood lead and hemoglobin among workers with different genotypes of ALAD
Compared with the ALAD_ (11) genotype workers, the blood lead concentration in the ALAD_ (12) genotype workers showed an increasing trend, but the difference was not statistically significant (P0.05). The hemoglobin level of the ALAD_ (12) genotype workers was significantly lower than that of the ALAD_ (11) genotype workers (P0.05).
5. Comparison of blood lead level and serum calcium level among workers with different genotypes of VDR
Workers with VDR_B alleles were significantly lower than those with VDR_ (BB) homozygous genotype (P0.05), while blood lead levels were significantly higher (P0.05).
conclusion
1, the lead smoke and lead dust concentration in the lead-acid battery factory are seriously exceeding the standard, causing a certain threat to the health of the workers. Although it is impossible to improve the working environment of the workers in the past few years, it is possible to reduce the effects of lead smoke and lead dust on the health of workers by strengthening individual protection measures.
2, ALAD and VDR gene polymorphisms can affect lead toxicity. ALAD_ (12) genotype workers are more susceptible to lead blood toxicity than ALAD_ (11) genotype workers. It is a susceptible population of lead toxicity; VDR_B allele is also one of the susceptible genes of lead toxicity. This mechanism may affect calcium metabolism and lead and calcium metabolic pathways with VDR gene polymorphism. It's similar.
【學位授予單位】：武漢科技大學
【學位級別】：碩士
【學位授予年份】：2012
【分類號】：R135.11

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