Assessment of cerebellar, vestibular and spinocerebellar effects of various factors using posuturography

目的：应用计算机姿势图和摆动频率分析技术，研究铅、有机溶剂(正己烷、二甲苯和甲苯)和沙林等职业和环境因素对前庭、小脑和脊髓小脑传入系统的影响。(1)49名男性硬脂酸铅接触者，年龄27~63岁(平均43岁)，同时血铅浓度(BPHS)为11~113(平均48)µg/100g，既往平均血铅浓度(BPHS)为7~52(平均24)µg/100g；(2)29名男性凉鞋、鞋类和皮革厂工人，年龄35~73(平均51)岁，尿2，5-己二酮(HD)0.41~3.06(平均1.20)mg/g肌酐；(3)男9例，女9例，年龄19~58岁(平均31岁)，在研究前6~8个月，因疑似恐怖袭击而意外接触沙林(1995年3月20日东京地铁沙林中毒)，血浆胆碱酯酶(CHE)13~131(平均72)IU/1。TH…的控制对象另有三组为“健康”志愿者，分别由(1)23名男性、(2)22名男性和(3)31名男性和24名女性组成。使用连接到微型计算机的测力台来测量体位平衡。用FFT方法计算每个频域的摆动功率；测量摆动路径的长度和面积；并确定每个摆动指标的Romberg商(RQS，闭眼与睁眼比率)。在铅作业工人中，高(2-4赫兹)和低(0-1赫兹)频率睁眼和闭眼的姿势摆动显著增加。睁眼时摆动0.5~2赫兹与并发BPB显著相关，而闭眼时高频摆动与既往平均BPB有关。有机溶剂作业工人闭眼高频摆动显著增加，1~4 Hz睁眼摆动与HD呈正相关，与尿甲基马尿酸浓度呈负相关。女性沙林中毒患者睁眼低频摆动明显增加。男性和女性中毒者低频摆动RQs与Log ChE显著相关，体位图改变提示铅对前庭-小脑、小脑前叶和脊髓小脑传入无明显影响，前庭-小脑改变反映铅同时吸收，小脑前部改变反映既往吸收。同样，正己烷影响前庭-小脑和脊髓-小脑的传入功能，二甲苯可能抑制前庭-小脑的传入功能。慢性(长期)前庭-小脑效应被认为是由急性沙林中毒引起的；女性可能比男性更容易受到影响。计算机化的姿势图结合频谱分析对前庭、小脑和脊髓小脑的传入功能的评估似乎是有用的。较少

To examine the effects of occupational and environmental factors such as lead, organic solvents (n-hexane, xylene and toluene) and sarin on vestibular, cerebellar and spinocerebellar afferent system using a computerized posturography with sway frequency analysis. The following three groups of subjects were examined : (1) 49 male chemical factory workers exposed to lead stearate, aged 27-63 (mean 43) years, with concurrent blood lead concentrations (BPhs) of 11-113 (mean 48) mug/10Og and past mean BPbs of 7-52 (mean 24) mug/100g ; (2) 29 male sandal, shoe and leather factory workers, aged 35-73 (mean 51) years, with urinary concentrations of 2,5-hexanedione (HD) of 0.41-3.06 (mean 1.20) mg/g creatinine ; and (3) 9 males and 9 females, aged 19-58 (mean 31) years, who exposed to accidentally sarin by a presumed terrorist attack (Tokyo Subway Sarin Poisoning, March 20, 1995) and showed plasma cholinesterase (ChE) of 13-131 (mean 72) IU/1 6-8 months before the study. Control subjects for th … More e three groups were "healthy" volunteers composed of (1) 23 males, (2) 22 males, and (3) 31 males and 24 females, respectively. Postural balance was measured using a force platform connected to a microcomputer. Power of the sway for each frequency domain was calculated by the FFT method ; length and area of the sway path were measured ; and Romberg quotients (RQs, eyes-closed to eyes-open ratios) for each sway measures were determined.In lead workers, the postural sway of high (2-4 Hz) and low (0-1 Hz) frequencies with eyes open and closed were significantly increased. The sway of 0.5-2 Hz with eyes open was significantly related to concurrent BPb ; whereas the sway of high frequency with eyes closed was related to past mean BPb. In organic solvent workers, the high frequency sway with eyes closed was significantly increased ; 1-4 Hz sway with eyes open was related positively to HD and inversely to methylhippurinc acid concentrations in urine. In female sarin poisoning patients, low frequency sway with eyes open was significantly increased. RQs for low frequency sway were significantly correlated with log ChE in both male and female poisoning patients.The pattern of the posturographic changes suggested that the vestibulo- cerebellum, anterior cerebellar lobe and spinocerebellar afferent were asymptomatically affected by lead ; the vestibulo-cerebellar change reflected concurrent lead absorption and the anterior cerebellar one reflected past absorption. Similarly, the vestibulo-cerebellar and spinocerebellar afferent function was affected by n-hexane ; the effect on vestibulo-cerebellar function was possibly inhibited by xylene. The chronic (long-term) vestibulo-cerebellar effect was considered to be induced by acute sarin poisoning ; females might be more susceptible than males. The computerized posturography with frequency analysis seems useful for assessment of vestibular, cerebellar and spinocerebellar afferent function. Less