宋斐翡, 杨晓娟, 殷金珠, 胡佳丽, 贾晓芳, 王昊, 李瑞, 牛侨, 路小婷. 职业性铝接触工人轻度认知功能障碍及分型研究[J]. 环境与职业医学, 2014, 31(4): 258-261. DOI: 10.13213/j.cnki.jeom.2014.0060
引用本文: 宋斐翡, 杨晓娟, 殷金珠, 胡佳丽, 贾晓芳, 王昊, 李瑞, 牛侨, 路小婷. 职业性铝接触工人轻度认知功能障碍及分型研究[J]. 环境与职业医学, 2014, 31(4): 258-261. DOI: 10.13213/j.cnki.jeom.2014.0060
SONG Fei-fei , YANG Xiao-juan , YIN Jin-zhu , HU Jia-li , JIA Xiao-fang , WANG Hao , LI Rui , NIU Qiao , LU Xiao-ting . Characteristics and Subtypes of Mild Cognitive Impairment Caused by Occupational Aluminum Exposure[J]. Journal of Environmental and Occupational Medicine, 2014, 31(4): 258-261. DOI: 10.13213/j.cnki.jeom.2014.0060
Citation: SONG Fei-fei , YANG Xiao-juan , YIN Jin-zhu , HU Jia-li , JIA Xiao-fang , WANG Hao , LI Rui , NIU Qiao , LU Xiao-ting . Characteristics and Subtypes of Mild Cognitive Impairment Caused by Occupational Aluminum Exposure[J]. Journal of Environmental and Occupational Medicine, 2014, 31(4): 258-261. DOI: 10.13213/j.cnki.jeom.2014.0060

职业性铝接触工人轻度认知功能障碍及分型研究

Characteristics and Subtypes of Mild Cognitive Impairment Caused by Occupational Aluminum Exposure

  • 摘要: 目的 通过现况调查研究铝职业接触人群的认知功能变化,筛检轻度认知功能障碍(MCI)患者并分型,探讨铝致MCI 亚型分布特点。

    方法 选择某铝厂电解工人及铝矿工人等共172例职业性铝接触工人,采用简易精神状态量表(MMSE)、画钟试验(CDT)、数字广度测验(DS)、物体记忆测验(FOM)、言语流畅性测验(RVR)等问卷测试工人的认知功能。采用石墨炉原子吸收分光光度法检测血铝含量。

    结果 以工人血铝含量均数(41.86μg/L)为界点将研究对象分为高血铝组(72.45& #177;9.25)μg/L与低血铝组(19.90& #177;10.65)μg/L,各组人数分别为70例、102例。高血铝组MMSE、CDT、DP、FOM及RVR实验得分明显低于低血铝组,差异均有统计学意义(P<0.05)。高血铝组MCI 检出率(28.6%)明显高于低血铝组(14.7%),差异有统计学意义(P<0.05)。高血铝组MCI 患者中遗忘型轻度认知功能障碍(aMCI)18例,低血铝组aMCI 8例,高血铝组aMCI 占MCI 的构成比(90.0%)明显高于低血铝组(53.3%),差异有统计学意义(P<0.05)。logistic 回归分析显示,工人年龄、铝接触工龄及血铝含量等因素是aMCI 主要影响因素。

    结论 长期职业性铝接触是MCI 发病的危险因素,且职业性铝接触引起的MCI 亚型以aMCI 为主。

     

    Abstract: Objective To describe the changes in cognitive function of an occupational population with exposure to aluminum, screen for mild cognitive impairment (MCI) patients, and probe into the subtype distributions.

    Methods Workers occupationally exposed to aluminum (n=172) including electrolysis and mining workers from an aluminum plant were enrolled to the present study. Questionnaires consisted of mini mental state examination (MMSE), clock drawing test (CDT), digit span (DS), fuld object memory (FOM), and rapid verbal retrieve (RVR), and were distributed to the workers for cognitive function evaluation. Graphite furnace atomic absorption spectrometry was used to detect blood aluminum content.

    Results A high n=70, (72.45& #177;9.25)μg/L and a low n=102, (19.90& #177;10.65)μg/L blood aluminum groups were divided by the mean level of blood aluminum (41.86 μg/L) of all workers' samples. The high blood aluminum group significantly scored higher in MMSE, CDT, DS, FOM, and RVR tests than the low blood aluminum group (P<0.05). The high blood aluminum group also reported a higher MCI detection rate (28.6%) than the low blood aluminum group (14.7%) (P<0.05). In this regard, the number of workers with amnestic mild cognitive impairment (aMCI) was 18 cases versus 8 cases in the high and the low blood aluminum groups respectively, and the aMCI/MCI ratio was also statistically higher in the high blood aluminum group than in the low group (90.0% versus 53.3%)(P<0.05). The results of logistic regression analysis showed that the main influencing factors leading to aMCI included age, length of exposure, and aluminum content in blood.

    Conclusion Long-term occupational exposure to aluminum is a risk factor for MCI, and aMCI is the predominant subtype.

     

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