手传振动作业工人冷水复温试验皮温变化特征及其影响因素

Characteristics and influencing factors of skin temperature changes in cold water rewarming test in hand-transmitted vibration workers

关键词: 手传振动  冷水复温  对称性  高血脂  关联性

Keywords: hand-transmitted vibration  cold water rewarming  symmetry  hyperlipidemia  relevance

摘 要: 目的 探索振动作业工人冷水复温试验(cold water rewarming test,CWRT)的皮温变化特征及其影响因素。方法 对 158 名接触手传振动中青年男工开展 CWRT,收集吸烟、饮酒、年龄和工龄等资料,测量血压,检测血糖、总胆固醇和三酰甘油等指标, 采用 Pearson χ² 检验分析冷水复温异常率;Mann-Whitney U 检验比较无名指皮温和复温时间,logistic 回归分析筛选冷水复温时间的影响因素。结果 左、右手基础皮温、冷试后即刻皮温和冷水复温时间[M(P₂₅,P₇₅)]分别为 32.65 (31.48,34.23)℃、12.75 (12.20,13.83)℃ 和 12.13 (8.84,17.75) min;32.90 (31.58,34.03)℃、12.70(12.00,13.53)℃和 12.23(9.04,18.15)min;左、右手冷试后 5、10 和 30min 复温异常率分别为 2.53%、5.06%和 10.13%;3.16%、5.70%和 11.39%,双手各项检测指标结果差异均无统计学意义(P>0.05)。经单因素分析,高血脂组工人左手冷水复温时间与非高血脂组比较差异有统计学意义(P<0.05);调整混杂因素后高血脂组增加左、右手冷水复温时间的风险分别是非高血脂组的 2.553 和 1.946 倍。结论 手传振动作业工人的左手和右手的基础皮温、冷试后即刻皮温、冷水复温时间和冷水复温异常率均呈对称性;冷水复温时间与高血脂有关联,高血脂可能是增加手指冷水复温时间的危险因素。

Abstract: Objective To explore the characteristics and influencing factors of skin temperature changes in cold water rewarming test (CWRT) in vibration exposed workers.Methods CWRT was conducted on 158 middle-aged and young male workers exposed to hand-transmitted vibration,the data such as smoking, drinking,age,length of service,etc.were collected,some basic indicators such as blood pressure,blood glucose, total cholesterol and triglyceride were detected also;then,Pearson χ² test was used to analyze the abnormal rate of cold water rewarming test,Mann-Whitney U test was used to compare the skin temperature of ring finger and cold water rewarming time,and logistic regression analysis was used to screen the influencing factors of cold water rewarming time.Results The results showed that the basic skin temperature,immediate skin temperature and cold water rewarming time of both hands that were skewed distribution then described as M(P₂₅,P₇₅):32.65(31.48,34.23)℃ ,12.75(12.20,13.83)℃ and 12.13 (8.84, 17.75) min for left hand,and 32.90 (31.58,34.03)℃,12.70(12.00,13.53)℃ and 12.23 (9.04,18.15) min for right hand;the rewarming abnormal rates of left hand at 5,10 and 30 minutes after CWRT were 2.53%, 5.06% and 10.13%,respectively,while those in right hand were 3.16%,5.70% and 11.39%,respectively,there were no statistically significant difference in all the detected indicators between left hands and right hands (P<0.05).According to univariate analysis,it was found that there was significant difference in the left hand cold water rewarming time between hyperlipidemia group and non-hyperlipidemia group (P<0.05);after adjusting for confounding factors,the risk of increasing cold water rewarming time of left and right hand in hyperlipidemia group was 2.553 and 1.946 times higher than that of non-hyperlipidemia group,respectively.Conclusion The results suggested that the basic skin temperature,immediate skin temperature after cold test,cold water rewarming time and abnormal rate of cold water rewarming test of the left and right hands of manual vibration workers are symmetrical;while cold water rewarming time was associated with hyperlipidemia,it was possible that hyperlipidemia may be a risk factor for increasing cold water rewarming time of fingers.