臺灣博碩士論文加值系統

雖然一般鉛的分析主要是以全血為主，但是鉛進入血液後約99%與紅血球之細胞膜及血紅素結合；近來有研究指出紅血球內及細胞膜上之血紅素鉛為結合型態不能擴散，對於身體的健康影響不若血清或血漿中的鉛。因為血清或血漿中的鉛具有較強的生化活性(biochemical availability)，血清或血漿中的鉛為自由形式，在近年的研究中指出血清或血漿鉛比全血鉛更能反應出血液中循環鉛的毒性，因為其比全血中的鉛應可以更自由地與周邊標的組織進行交換(如:腦、腎臟、骨骼、神經系統)；所以血清鉛可作為鉛毒性的可靠指標。但是因為分析方法的限制，目前血漿或血清鉛對健康影響的研究並不多。本研究主要是探討鉛作業勞工血清鉛濃度對健康的影響及血清鉛和全血鉛的關係；本研究在分析鉛工人血清鉛與健康效應關係前，第一部份我們想先探討血清鉛濃度是否會隨著儲存於採血管中時間增加而增加。
第一部份結果顯示血清儲存於採血管中一週內並不會顯著地影響其鉛濃度；第二部份結果顯示全血鉛與血紅素(HB)、血球比溶(HCT)皆未達統計上顯著相關；血清鉛對數值與血紅素(HB)亦未達統計上顯著相關，血清鉛對數值與血球比溶(HCT)為負相關，但我們發現血清鉛對數值影響HCT並非直線模型，用拋物線模型更能解釋血清鉛-全血鉛與全血鉛非線性關係，同時性別不同影響效果不同，所以血清鉛對數值比全血鉛對於HB或HCT為更適當之鉛暴露指標，但對於其他的健康效應，仍需要更進一步的研究。

Although the whole blood lead measurement is currently used widely, about 99% of lead in blood is considered to be distributed in erythrocytes and which is a non-diffusible lead bound to the hemoglobin and the erythrocyte membrane. Only about 1% of lead in serum or plasma is considered to be diffusible and has greater bioavailability than lead in erythrocytes. Several investigators have proposed that plasma or serum Pb levels may better reflect the fraction of circulatory Pb that is more freely available for exchange with peripheral target tissues (e.g., brain, kidney, skeleton). At present there are few studies about the health effects of serum or plasma lead. Therefore, we have conducted a cross-sectional study to investigate the relationship between Pb in whole blood and serum and comparison of the effects of blood lead and serum lead on health among occupational lead-exposed workers in a battery factory. Before the assessment, we assessed if the serum lead concentrations will be stable in one-week storage days.
The present data show that the serum lead did not significantly change when stored in a Vacutainer during one week. The second, we found that whole blood lead concentrations did not significantly correlated to hemoglobin nor haematorcrit. However, we found that natural log transformed serum lead concentrations inversely correlated to hemoglobin and haematocrit. But we found that the association of the natural log transformed serum lead concentrations and haematocrit is nonlinear . The parabola is the best model in our study. Therefore serum lead is a better exposure marker than whole blood lead to the effect on hemopoiesis. The present study also clearly shows that the relation between serum lead and whole blood is exponential. The association between serum lead levels and the other health effects need further study and assessment.

目錄
第一章 緒論
第一節 研究動機.....................................1
第二節 研究目的.....................................2
第二章 文獻探討
第一節 鉛之暴露途徑與來源...........................4
第二節 鉛之健康危害 ................................5
第三節 血清鉛之研究.................................8
第三章 利用ICP-MS進行採血管中血清鉛內在動態平衡評估-13~28
第四章 鉛作業工人血清鉛及健檢資料分析
第一節 研究架構....................................29
第二節 研究對象....................................30
第三節 方法與工具..................................31
第四節 統計分析....................................32
第五章 分析結果
第一節 描述性統計.......................................36
第二節 推論性統計.......................................41
第三節 血清鉛與全血鉛的關係.............................42
第六章 討論........................................... .67
參考文獻.................................................70

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