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目的探讨长期锰接触工人脑锰蓄积及其与血Mn、Mg、Zn、Fe、Ca、Cu含量变化的关系,为锰中毒早期诊断及防治提供科学依据。方法选择广西某厂锰接触无症状冶炼工人13例(接锰平均浓度0.76mg/m3)、锰中毒工人4例(均已脱离锰接触20年以上)、非锰接触对照工人6例,采用美国GE公司生产的GE signa1.5MR/i超导磁共振成像(MRI)仪依次进行轴位FSET2加权像(WI)、轴位T1 flair T1WI、冠状位或矢状位T1 flair T1WI检查,在轴位T1 flair T1WI上测量苍白球和同侧额叶白质的信号强度,根据公式苍白球指数(PI)=苍白球信号强度/额叶白质的信号强度×100%来计算。采用电感偶合等离子发射光谱法(ICP-AES)测定血Mn、Mg、Zn、Fe、Ca、Cu含量。结果锰接触、中毒组分别有92.3%、25.0%的工人苍白球MRI T1WI信号增强、T2WI信号正常,锰接触工人PI平均值显著高于对照组及锰中毒组(P<0.01)。锰接触工人红细胞锰(RBCMn)分别与PI、血锰(MnB)呈正相关(P<0.05)。结论苍白球MRI T1WI高信号可反映近期锰接触,PI可反映锰在中枢神经系统蓄积,PI和RBCMn含量可作为锰神经毒性的早期暴露生物标志物。
Objective To explore the relationship between brain manganese accumulation and the changes of Mn, Mg, Zn, Fe, Ca and Cu contents in long-term manganese exposure workers and provide a scientific basis for the early diagnosis and prevention of manganese poisoning. Methods Thirteen patients with manganese contact asymptomatic smelters in Guangxi were selected (average concentration of manganese was 0.76 mg / m3), 4 manganese poisoning workers (all of them were separated from manganese for more than 20 years), 6 were non-manganese exposure workers, The GE signa1.5 MR / i superconducting magnetic resonance imaging (MRI) instrument manufactured by GE Company was followed by axial FSET2 weighted imaging (WI), axial T1 flair T1WI, coronal or sagittal T1 flair T1WI, The signal intensity of globus pallidus and ipsilateral frontal white matter measured on the T1 flair T1WI was calculated according to the formula Pallidum index (PI) = globus pallidus signal intensity / frontal white matter signal intensity × 100%. The contents of Mn, Mg, Zn, Fe, Ca and Cu in blood were determined by inductively coupled plasma-atomic emission spectrometry (ICP-AES). Results In the manganese exposure and poisoning groups, 92.3% and 102.0% of workers respectively had MRI T1WI signal enhancement and T2WI signal normalization. The average value of PI in manganese exposed workers was significantly higher than that in control group and manganese poisoning group (P <0.01). Manganese exposed workers RBCMn were positively correlated with PI and MnB (P <0.05). Conclusions The pallidolus MRI T1WI high signal can reflect recent manganese exposure. PI can reflect the accumulation of manganese in the central nervous system, and PI and RBCMn contents can serve as early exposure biomarkers of manganese neurotoxicity.