摘要
目的分析在模拟手工搬举作业的持续工效学负荷作用下的局部肌肉反应,筛选疲劳进程中的敏感代谢性生物标志物。方法采用单纯随机抽样方法,选择13名健康男性志愿者为研究对象,进行4个时段(T1~T4)的重复性模拟手工搬举作业,每个时段12 min。采用《Borg 6-20主观疲劳等级(RPE)量表》评估其前臂、上臂、肩部、背部、腿部5个部位相应肌肉和全身的作业疲劳程度。在每2个时段之间采集肘静脉血,检测血清中8种代谢性标志物氨、乳酸、肌酸激酶、乳酸脱氢酶(LDH)、Ⅰ型胶原质C末端端肽(CTX-Ⅰ)、Ⅱ型胶原质C末端端肽(CTX-Ⅱ)、软骨寡聚基质蛋白(COMP)和钙离子的水平。结果搬举作业中,研究对象身体5个部位相应肌肉与全身的RPE得分均随着搬举时段的增加而增加(P值均<0.01);目标肌肉均出现疲劳,全身疲劳出现时间在T2时段。研究对象T1~T4时段血清中氨、乳酸、肌酸激酶、LDH、COMP和钙离子水平均高于T0时段(P值均<0.05);血清中CTX-Ⅰ水平在T1和T3时段均高于T0时段(P值均<0.05),血清中CTX-Ⅱ水平在T1、T2和T4时段均高于T0时段(P值均<0.05)。上述8种血清代谢性标志物水平在T1~T4时段存在波动;其中,血清中肌酸激酶水平随着搬举时段的增加而增加(P值均<0.05),血清中乳酸水平在T3时段分别高于T1和T2时段(P值均<0.05),血清中LDH和钙离子水平在T2~T4时段均高于T1时段(P值均<0.05),血清中COMP水平在T2和T3时段均高于T1时段(P值均<0.05)。除CTX-Ⅰ外,疲劳后血清中其余7种代谢性标志物水平均高于疲劳前(P值均<0.05)。结论代谢性标志物血清氨、乳酸、肌酸激酶、钙离子、LDH、CTX-Ⅱ和COMP在疲劳前后变化显著,在重复性作业活动中可作为评价疲劳的敏感指标。
Objective To analyze the local muscle response under continuous ergonomic workload by simulating manual lifting,and to screen the sensitive metabolic biomarkers during fatigue process.Methods A total of 13 healthy male volunteers were selected as the study subjects using simple random sampling method.Study subjects underwent repetitive simulated manual lifting for four periods(T1 to T4),each lasting 12 minutes.The degree of work-related fatigue in the forearm,upper arm,shoulder,back,and leg muscles,and the whole body was accessed using Borg 6-20 Rating of Perceived Exertion(RPE)Scale.The venous blood samples were collected from elbow between each two periods to detect the levels of eight metabolic biomarkers:ammonia,lactate,creatine kinase,lactate dehydrogenase(LDH),C-terminal telopeptide of type Ⅰ collagen(CTX-Ⅰ),C-terminal telopeptide of type Ⅱ collagen(CTX-Ⅱ),cartilage oligomeric matrix protein(COMP),and calcium ions.Results The RPE scores of the study subjects for the muscles of five body parts and the whole body increased with the increasing lifting periods(all P<0.01).Fatigue was observed in all target muscles,with overall body fatigue occurring in the T2 period.The levels of ammonia,lactate,creatine kinase,LDH,COMP,and calcium ions in the serum of study subjects were higher in the T1 to T4 periods than in the T0 period(all P<0.05).The serum CTX-Ⅰ level was higher in the T1 and T3 periods than that in the T0 period(all P<0.05),and the serum CTX-Ⅱ level was higher in the T1,T2 and T4 periods than that in the T0 period(all P<0.05).The level of these eight serum metabolic biomarkers fluctuated during the T1 to T4 periods.The serum creatine kinase level increased with the period of lifting(all P<0.05).The serum lactate level was higher in the T3 period than those in the T1 and T2 periods(all P<0.05).The serum LDH and calcium ion levels were higher in the T2 to T4 periods than that in the T1 period(all P<0.05).The serum COMP level was higher in the T2 and T3 periods than that in the T1 period(all P<0.05).Except for CTX-Ⅰ,the levels of other seven metabolic markers in serum were higher in individuals after fatigue than before fatigue(all P<0.05).Conclusion Serum metabolic biomarkers such as ammonia,lactate,creatine kinase,calcium ions,LDH,CTX-Ⅱ,and COMP exhibit significant changes before and after fatigue.These metabolic biomarkers could be used as sensitive biomarkers for evaluating muscle fatigue during repetitive works.
作者
钟思武
贾宁
曲颖
张雪艳
徐擎
杨燕
王致
王忠旭
ZHONG Siwu;JIA Ning;QU Ying;ZHANG Xueyan;XU Qing;YANG Yan;WANG Zhi;WANG Zhongxu(Occupational Health Monitoring Center,Guangzhou Twelfth People′s Hospital,Guangzhou Occupational Disease Prevention and Treatment Hospital,Guangzhou,Guangdong 510620,China;不详)
出处
《中国职业医学》
CAS
北大核心
2023年第6期607-612,共6页
China Occupational Medicine
基金
国家重点研发计划项目(2022YFC2503205)
中国疾病预防控制中心职业卫生与中毒控制所职业健康风险评估与国家职业卫生标准制定项目(131031109000160004)
广州市科学技术局重点研发计划项目(202206010061)
广州市医学重点学科建设项目(2021—2023年)
广州市市校(院)企联合资助专题(广州市职业环境与健康重点实验室)(2023A03J0502)
关键词
肌肉疲劳
生物标志物
氨
乳酸
肌酸激酶
乳酸脱氢酶
胶原质C末端端肽
软骨寡聚基质蛋白
钙离子
Muscle fatigue
Biomarkers
Ammonia
Lactate
Creatine kinase
Lactate dehydrogenase
C-terminal telopeptide of collagen
Cartilage oligomeric matrix protein
Calcium ion
作者简介
钟思武(1990—),男,医学硕士,主管医师,主要从事职业工效学研究;通信作者:王忠旭,研究员,硕士研究生导师,E-mail:wangzhongxu2003@163.com;通信作者:王致,主任医师,博士研究生导师,E-mail:zhi_wang@outlook.com
