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目的探讨手传振动作业对机体体液免疫功能的影响。方法以328名男性手传振动作业工人为接振组,按照职业病诊断结论分为观察对象亚组(观察对象31例),轻度亚组(轻度职业性手臂振动病224例),中度亚组(中、重度职业性手臂振动病分别有67、6例,共73例);以203名无手传振动和其他职业病危害因素接触史的健康男性人员为对照组。检测2组人群免疫球蛋白(Ig)A、Ig G、Ig M、补体(C)3和C4水平。比较各组人群上述体液免疫指标水平和异常率,并分析其影响因素。计量资料采用中位数和第25、75百分位数描述。结果接振组Ig A、Ig G和C3水平均低于对照组[1.71(1.27,2.23)vs 2.13(1.62,2.68)g/L,10.42(8.54,12.56)vs 12.06(10.51,14.46)g/L,1.08(0.95,1.23)vs 1.15(1.03,1.31)g/L,P<0.01]。接振组轻度亚组和中度亚组Ig A与C3水平分别低于观察对象亚组[Ig A:1.68(1.27,2.21)vs 1.94(1.42,2.95)g/L,1.63(1.23,2.08)vs 1.94(1.42,2.95)g/L,P<0.05;C3:1.08(0.94,1.23)vs 1.21(1.06,1.31)g/L,1.02(0.92,1.15)vs 1.21(1.06,1.31)g/L,P<0.05];接振组中度亚组Ig G水平分别低于观察对象亚组和轻度亚组[9.49(7.84,11.29)vs 11.77(9.96,13.07)g/L,9.49(7.84,11.29)vs 10.47(8.61,12.85)g/L,P<0.05]。对照组均无检出Ig A、Ig G、Ig M、C3和C4异常者,接振组上述指标异常检出率分别为4.27%、3.66%、2.74%、2.74%和4.88%,均高于对照组(P<0.01)。多元线性回归分析显示,在排除接振工龄、吸烟、饮酒、年龄和听力损失5个混杂因素后,Ig G、C3和C4水平均与接触手传振动呈负相关(P≤0.01);Ig A和Ig M水平与接触手传振动不相关(P>0.05)。结论手传振动可影响机体体液免疫功能,导致免疫功能下降。
Objective To explore the impact of hand-vibration operation on humoral immune function. Methods According to the diagnosis of occupational diseases, 328 males and 15 females were divided into observation subgroup (observation group of 31 cases), mild subgroup (224 cases of mild occupation arm vibration disorder), moderate Subgroups (67.6 cases of moderate and severe occupational arm vibration, respectively, a total of 73 cases); to 203 non-hand vibration and other occupational hazards exposure history of healthy male staff as the control group. Immunoglobulins (Ig) A, Ig G, Ig M, complement (C) 3 and C4 were measured in two groups. The level of humoral immunity index and abnormal rate in each group were compared and the influencing factors were analyzed. The measurement data is based on the median and the 25th and 75th percentiles. Results The levels of Ig A, Ig G and C3 in the vibration group were significantly lower than those in the control group [1.71 (1.27,2.23) vs 2.13 (1.62,2.68) g / L, 10.42 (8.54,12.56) vs 12.06 (10.51,14.46) g / L, 1.08 (0.95, 1.23) vs 1.15 (1.03, 1.31) g / L, P <0.01]. The levels of Ig A and C3 in mild and moderate subgroups were lower than those in subgroups [Ig A: 1.68 (1.27,2.21) vs 1.94 (1.42,2.95) g / L, 1.63 ) vs 1.94 (1.42, 2.95) g / L, P <0.05; C3: 1.08 (0.94,1.23) vs 1.21 (1.06,1.31) g / L, 1.02 (0.92,1.15) vs 1.21 L, P <0.05]. The level of Ig G in the moderate subgroup of the vibration receiving group was lower than that in the subgroup of the subgroup and the mild subgroup [9.49 (7.84,11.29) vs 11.77 (9.96,13.07) g / L, 9.49 , 11.29) vs 10.47 (8.61, 12.85) g / L, P <0.05]. No abnormalities of Ig A, Ig G, Ig M, C3 and C4 were detected in the control group, and the abnormal detection rates of the above indexes were 4.27%, 3.66%, 2.74%, 2.74% and 4.88% Control group (P <0.01). Multivariate linear regression analysis showed that Ig G, C3 and C4 levels were negatively correlated with contact hand vibration (P≤0.01) after excluding 5 confounders, including age, smoking, drinking, age and hearing loss, and Ig A And Ig M levels were not related to contact hand vibration (P> 0.05). Conclusion hand vibration can affect the body’s humoral immune function, leading to decreased immune function.