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目的分析中青年铝作业工人认知记忆功能的特征性改变情况。方法采用整群抽样方法,以358名从事铝电解作业1.0年以上的19.0~55.0岁作业工人为研究对象,采用简易精神状态检查量表(MMSE)、画钟试验(CDT)、数字广度测试[DST,包括正序测试(DSFT)与倒序测试(DSBT)]、词语流畅性测验(VFT)、物体记忆测验(FOME)和简单反应时(SRT)测试评价其认知记忆功能;采用石墨炉原子吸收法测定研究对象血铝水平作为内接触指标,根据其中位数(M)和第25、75百分位数(P25,P75)分为低、中和高铝接触组。结果研究对象血铝水平M(P25,P75)为135.47(87.42,202.24)μg/L。高铝接触组人群DST、DSFT和VFT得分分别低于低、中铝接触组[DST:16(13,19)vs 18(14,21)分,16(13,19)vs 18(15,20)分,P<0.05;DSFT:10(8,12)vs 11(8,12)分,10(8,12)vs 11(9,12)分,P<0.05;VFT:36(26,46)vs 40(30,50)分,36(26,46)vs 40(30,50)分,P<0.05]。3组人群MMSE、CDT、DSBT、FOME得分和SRT分别比较,差异均无统计学意义(P>0.05)。多元逐步线性回归分析结果显示,血铝水平与VFT得分呈负相关(P<0.05),随血铝水平的升高,VFT得分下降;MMSE、CDT、FOME得分和SRT与血铝水平均无关联(P>0.05)。结论长期职业性铝接触可对中青年作业工人的记忆功能造成损害,主要发生在听觉注意力、听觉记忆广度和言语执行功能方面,并呈现一定的剂量-效应关系。
Objective To analyze the characteristic changes of cognitive memory function among young and middle-aged aluminum working workers. Methods A total of 358 workers aged 19.0-55.0 years working in aluminum electrolysis over 1.0 years were enrolled in this study. The MMSE, CDT, DST, including DSFT and DSBT, VFT, FOME and SRT were used to evaluate the cognitive memory function. Graphite furnace atomic Absorption method was used to determine the level of blood aluminum as the internal contact index. According to its median (M) and the 25th and 75th percentiles (P25, P75), it was divided into low, medium and high aluminum exposure groups. Results The blood levels of aluminum (M25, P25, P75) in the study subjects were 135.47 (87.42,202.24) μg / L. The scores of DST, DSFT and VFT in high aluminum exposure group were lower than those in low aluminum exposure group [DST: 16 (13,19) vs 18 (14,21), 16 (13,19) vs 18 (15,20 ), P <0.05; DSFT: 10 (8,12) vs 11 (8,12), 10 (8,12) vs 11 ) vs 40 (30,50), 36 (26,46) vs 40 (30,50), P <0.05]. MMSE, CDT, DSBT, FOME scores and SRT scores of the three groups were not significantly different (P> 0.05). The results of multivariate stepwise linear regression analysis showed that there was a negative correlation between blood aluminum levels and VFT scores (P <0.05). VFT scores decreased with the increase of blood aluminum levels. MMSE, CDT, FOME scores and SRT were not correlated with blood aluminum levels (P> 0.05). Conclusion Long-term occupational exposure to aluminum can damage the memory function of middle-aged and young workers mainly in terms of auditory attention, breadth of auditory memory and speech executive function, and show some dose-effect relationship.