摘要
目的 利用电感耦合等离子质谱法测定血液和尿液中10种重金属元素含量,比较金属元素含量的不同,为白血病的防控措施提供参考依据.方法 本研究选择经骨髓检查初次确诊的白血病患者65例为病例组,随机选择同期、同医院住院的非白血病患者65例为对照组,按年龄(±5岁)、性别进行1∶1配对.收集患者晨尿及血液样本,采用电感耦合等离子质谱法(ICP-MS)检测血液和尿液样品中10种重金属元素含量,并计算加标回收率,最后比较病例组和对照组差异,将病例组与对照组的血液和尿液中共同变化的重金属Pb,Mn和Se进行二元Logistic回归分析.结果 经优化后检测方法回收率为89.00％～109.00％;白血病患者血清中铬(Cr)、铜(Cu)、镉(Cd)、铅(Pb)的含量均高于对照组血清中的含量(P＜0.05),而锰(Mn)、硒(Se)、汞(Hg)的含量均低于对照组血清中的含量(P＜0.05);白血病患者尿液中锌(Zn)、铅(Pb)的含量均高于对照组血清中的含量(P＜0.05),而锰(Mn)、砷(As)、硒(Se)、镉(Cd)、汞(Hg)的含量均低于对照组尿液中的含量(P＜0.05),通过比较得出病例组与对照组的血液和尿液共同变化的重金属为Pb、Mn和Se,其中Pb含量升高,Mn和Se降低,二元Logistic回归分析显示Mn和Pb与白血病的患病具有一定联系(P＜0.05).结论 白血病患者血清及尿液中重金属含量较对照组发生变化,重金属元素Mn和Pb可能与白血病的患病具有一定联系.
Abstract
Objective The contents of 10 kinds of heavy metals in blood and urine were determined by induc-tively coupled plasma mass spectrometry,and the differences of metal elements were compared to provide reference for the prevention and control of leukemia.Methods In this study,sixty five patients with leuke-mia diagnosed for the first time by bone marrow examination were selected as the case group,and 65 non-leu-kemia patients hospitalized in the same hospital during the same period were randomly selected as the control group,and 1∶1 matching was performed according to age(±5 years old)and sex.The morning urine and blood samples of patients were collected,and the contents of 10 heavy metals in the blood and urine samples were detected by inductively coupled plasma mass spectrometry(ICP-MS),and the standard recovery rate was calculated.Finally,the differences between the case group and the control group were compared,and the common changes of heavy metal Pb in the blood and urine of the case group and the control group were com-pared.Binary Logistic regression analysis was performed for Mn and Se.Results The recoveries of the opti-mized methods were 89.00％～109.00％.The contents of chromium(Cr),copper(Cu),cadmium(Cd)and lead(Pb)in serum of leukemia patients were higher than those of control group(P＜0.05),while the con-tents of manganese(Mn),selenium(Se)and mercury(Hg)were lower than those of control group(P＜0.05).The contents of zinc(Zn)and lead(Pb)in urine of leukemia patients were higher than those in serum of control group(P＜0.05),while the contents of manganese(Mn),arsenic(As),selenium(Se),cadmium(Cd)and mercury(Hg)were lower than those in urine of control group(P＜0.05).Through comparison,it was concluded that the heavy metals in the blood and urine of the case group and the control group were Pb,Mn and Se,in which the content of Pb increased while Mn and Se decreased.Binary Logistic regression analysis showed that Mn and Pb had a certain relationship with the incidence of leukemia(P＜0.05).Conclu-sion The content of heavy metals in serum and urine of leukemia patients was changed compared with that of control group,among which heavy metals Mn and Pb were associated with the occurrence of leukemia,which could provide reference for the prevention and control measures of leukemia.
维普
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