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体内镉水平对死亡率的影响仍然存在争论。研究探讨环境镉暴露人群高死亡率以及尿镉与死亡率之间的剂量反应关系。研究对象为日本镉污染区梯川的Kakehashi河盆地3119名居民,在1981年~1982年间对居民尿镉水平进行检测,随后进行15年的随访研究。研究结果发现,在控制年龄影响后,使用Cox比例危险模型分析,无论男女高尿镉组的死亡危险高于低尿镉组。按照尿镉量将研究对象分为5个组,控制年龄影响后,尿镉≥3μg/g肌酐组死亡危险随着尿镉量的增加而显著地成比例增加,且女性中尤其明显。此外,经对受试者的某些特定死因研究表明,高尿镉组心衰死亡危险性均高于低尿镉组,而没有确切死因的个体的最终诊断通常是心衰;女性高尿镉组的肾病死亡危险要显著高于低尿镉组。研究结果表明,在环境镉暴露的居民当中,体内镉含量与死亡率之间存在某种因果联系,但除了导致肾病之外不会导致其他特定疾病发生。
The impact of cadmium levels in vivo on mortality remains controversial. The study investigated the relationship between high mortality in cadmium-exposed populations and urinary cadmium and mortality. The study was conducted on 3119 residents of the Kakehashi River Basin in the Laichuan River, a cadmium-contaminated area in Japan. The urinary cadmium levels were measured between 1981 and 1982, followed by a 15-year follow-up study. The results of the study found that after controlling for age effects, the Cox proportional hazard model was used to analyze whether the risk of death from the high urine cadmium group was higher in the men and women than in the low urinary cadmium group. According to the amount of urinary cadmium, the subjects were divided into 5 groups. After controlling for age, the risk of death from urinary cadmium ≥ 3 μg/g creatinine group increased significantly in proportion with the increase of urinary cadmium, especially in women. In addition, according to some specific causes of death in subjects, the risk of death from heart failure in the high urinary cadmium group was higher than that in the low urinary cadmium group, and the final diagnosis of individuals with no definite cause of death was usually heart failure; women with high urinary cadmium The risk of death from kidney disease was significantly higher in the group than in the low urinary cadmium group. The results of the study indicate that there is a causal link between cadmium levels and mortality in residents exposed to environmental cadmium, but they do not cause specific diseases other than kidney disease.