论文部分内容阅读
[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±9.25)μg/L]与低血铝组[(19.90±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。
[Objective] To investigate the changes of cognitive function in exposed occupationally exposed individuals through screening of patients with mild cognitive impairment (MCI) and investigate the distribution of MCI subtypes induced by aluminum. [Methods] A total of 172 occupational aluminum exposed workers, including electrolytic workers and aluminum miners in an aluminum plant, were selected. The MMSE, CDT, DS and object memory test (FOM), verbal fluency test (RVR) and other questionnaires to test the cognitive function of workers. Graphite furnace atomic absorption spectrophotometry was used to detect blood aluminum content. [Results] The subjects were divided into high blood aluminum group ([72.45 ± 9.25] μg / L] and low blood aluminum group [(19.90 ± 10.65) μg / L], the number of each group were 70 cases, 102 cases. The scores of MMSE, CDT, DP, FOM and RVR in high blood aluminum group were significantly lower than those in low blood aluminum group, the difference was statistically significant (P <0.05). The detection rate of MCI in high blood aluminum group (28.6%) was significantly higher than that in low blood aluminum group (14.7%), the difference was statistically significant (P <0.05). 18 cases of amnestic mild cognitive impairment (aMCI), 8 cases of aMCI of low blood aluminum group and 90% of aMCI in high blood aluminum group were significantly higher than those in low blood aluminum group (53.3%), the difference was statistically significant (P <0.05). Logistic regression analysis showed that the main factors affecting aMCI were the age of workers, length of exposure to aluminum, and blood aluminum content. [Conclusion] Long-term occupational exposure to aluminum is a risk factor for the pathogenesis of MCI. The MCI subtype caused by occupational exposure to aluminum is dominated by aMCI.