李聪, 吴奇峰, 邓小峰, 张海玲, 梁伟辉, 杨爱初. 职业性手臂振动病患者血管紧张素、醛固酮含量及肾素活性变化[J]. 环境与职业医学, 2020, 37(4): 358-362. DOI: 10.13213/j.cnki.jeom.2020.19692
引用本文: 李聪, 吴奇峰, 邓小峰, 张海玲, 梁伟辉, 杨爱初. 职业性手臂振动病患者血管紧张素、醛固酮含量及肾素活性变化[J]. 环境与职业医学, 2020, 37(4): 358-362. DOI: 10.13213/j.cnki.jeom.2020.19692
LI Cong, WU Qi-feng, DENG Xiao-feng, ZHANG Hai-ling, LIANG Weihui, YANG Ai-chu. Changes of angiotensin and aldosterone levels and renin activity in patients with occupational hand-arm vibration disease[J]. Journal of Environmental and Occupational Medicine, 2020, 37(4): 358-362. DOI: 10.13213/j.cnki.jeom.2020.19692
Citation: LI Cong, WU Qi-feng, DENG Xiao-feng, ZHANG Hai-ling, LIANG Weihui, YANG Ai-chu. Changes of angiotensin and aldosterone levels and renin activity in patients with occupational hand-arm vibration disease[J]. Journal of Environmental and Occupational Medicine, 2020, 37(4): 358-362. DOI: 10.13213/j.cnki.jeom.2020.19692

职业性手臂振动病患者血管紧张素、醛固酮含量及肾素活性变化

Changes of angiotensin and aldosterone levels and renin activity in patients with occupational hand-arm vibration disease

  • 摘要: 背景

    职业性手臂振动病(OHAVD)患者存在手部末梢循环障碍和/或手臂神经功能障碍,肾素-血管紧张素-醛固酮系统是人体内的一种升压调节体系,可引起血管平滑肌收缩。该系统中的血管紧张素(Ang)不仅可引起血管收缩,还能产生促炎效应,使血管内皮细胞凋亡,从而损伤血管组织。

    目的

    探讨肾素-血管紧张素-醛固酮系统是否参与OHAVD的血管损伤。

    方法

    采用整群抽样法,以2016年5月-2019年5月在广东省职业病防治院住院的90名OHAVD患者为OHAVD组,根据职业病诊断前有无发生振动性白指(VWF)分为有VWF亚组和无VWF亚组;以同一公司内工龄、年龄相近的70名无职业性手传振动接触史的人员为对照组。检测OHAVD组与对照组人群晨起空腹静卧状态下静脉血浆血管紧张素Ⅰ(Ang Ⅰ)(37℃、4℃时)、血管紧张素Ⅱ(Ang Ⅱ)及醛固酮(ALD)含量、肾素活性(PRA)及醛固酮-肾素活性比值(ARR),比较各组间上述指标及其异常率的差异。

    结果

    OHAVD组Ang Ⅰ(37℃)含量、Ang Ⅰ(4℃)含量、PRA、ALD含量、ARR的MMin,Max)分别为2.29(0.55,8.30)μg·L-1、0.68(0.25,2.07)μg·L-1、1.63(0.26,6.58)μg·L-1·h-1、122.01(63.45,620.96)ng·L-1和7.88(2.12,171.48),Ang Ⅱ含量(x±s)为(56.56±13.58)ng·L-1。OHAVD组人群ALD含量低于对照组137.59(60.97,651.17)ng·L-1P < 0.05),其余指标的差异均无统计学意义(P>0.05)。两亚组人群间各指标差异均无统计学意义(P>0.05)。各指标的异常率在两组人群及两亚组人群间的差异均无统计学意义(P>0.05)。

    结论

    本研究未发现肾素-血管紧张素-醛固酮系统参与OHAVD的振动性血管损伤的证据。

     

    Abstract: Background

    Patients with occupational hand-arm vibration disease (OHAVD) have hand peripheral circulation disorders and/or arm nerve dysfunction. The renin-angiotensin-aldosterone system is a pressure-regulating system in human body, which can cause contraction of vascular smooth muscles. Angiotensin (Ang) in this system can not only cause vasoconstriction, but also produce proinflammatory effects, inducing apoptosis of vascular endothelial cells and damage to vascular tissues.

    Objective

    This study is conducted to investigate whether the renin-angiotensin-aldosterone system is involved in developing OHAVD-related vascular injury.

    Methods

    Using cluster sampling, 90 patients with OHAVD hospitalized in Guangdong Province Hospital for Occupational Disease Prevention and Treatment from May 2016 to May 2019 were selected as the OHAVD group, and the patients were divided into vibratory white finger (VWF) and non-VWF subgroups based on VWF occurrence before the OHAVD diagnosis. Another 70 office clerks without hand-transmitted vibration exposure history and of similar seniority and age as the OHAVD group from the same company were selected as the control group. Ang Ⅰ (37℃), Ang Ⅰ (4℃), Ang II, and aldosterone (ALD) levels, as well as renin activity (PRA) and aldosterone-renin activity ratio (ARR) in morning fasting venous plasma of all participants were measured. The differences in above indicators and their abnormal rates were compared.

    Results

    The AngⅠ (37℃) level, AngⅠ(4℃) level, PRA, ALD level, and ARR in M (Min, Max) in the OHAVD group were 2.29 (0.55, 8.30) μg·L-1, 0.68 (0.25, 2.07) μg·L-1, 1.63 (0.26, 6.58) μg·L-1·h-1, 122.01 (63.45, 620.96) ng·L-1, and 7.88 (2.12, 171.48), respectively, and the Ang Ⅱ level in (x±s) was (56.56±13.58) ng·L-1. The ALD level in the OHAVD group was lower than that in the control group137.59 (60.97, 651.17) ng·L-1 (P < 0.05), and the differences in the other indicators were not statistically significant between the two grpups (P>0.05). There were no differences in all indicators between the two subgroups (P>0.05). There were also no differences in the abnormal rates of above indicators between the two groups and between the two subgroups (P>0.05).

    Conclusion

    No evidence is found in the study that the renin-angiotensin-aldosterone system is involved in vibrational vascular injury of OHAVD.

     

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