摘要目的:探讨广东某铀矿周围不同居住距离中老年男性居民炎性指标水平及其影响因素，为铀矿周围居民健康风险评估提供科学数据。方法:采用分层抽样方法以铀矿为中心，按铀矿周围距离<10 km和10～20 km的半径范围分两组，抽取常住中老年男性居民作为调查对象，采用面对面问卷调查获取基本人口社会学特征和生活方式等信息。按照标准方法测量调查对象身高体重并计算体质量指数(BMI)，采集静脉血并检测C反应蛋白(CRP)、补体C3、补体C4、白细胞数目、淋巴细胞数目、中性粒细胞数目、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)等炎性指标水平。采用多重线性回归对各项指标影响因素进行分析。结果:共纳入常住中老年男性居民867人，其中10～20 km组431人，平均年龄(51.54±5.37)岁；<10 km组436人，平均年龄(52.05±5.24)岁。多重线性回归结果显示，某铀矿距离分组与中老年男性居民的补体C4水平( β＝0.014，95% CI：0.001～0.027)、淋巴细胞数目( β＝0.086，95% CI：0.003～0.168)呈现正相关( t＝2.07、2.04， P<0.05)；年龄与补体C4( β＝0.018，95% CI：0.004～0.031)水平呈正相关( t＝2.50， P<0.05)，与TNF-α( β＝－63.022，95% CI：－101.114～－24.929)、IL-6( β＝－14.694，95% CI：－24.396 ～ －4.992)水平呈负相关( t＝－3.25、－2.97， P<0.05)。吸烟与白细胞数目( β＝0.630，95% CI：0.341～0.918)、淋巴细胞数目( β＝0.226，95% CI：0.134～0.319)、中性粒细胞数目( β＝0.372，95% CI：0.143～0.601)呈正相关( t＝4.29、4.81、3.19， P<0.05)，与TNF-α( β＝－43.551，95% CI：－84.778～－2.324)、IL-6( β＝－10.603，95% CI：－21.103～－0.102)水平呈负相关( t＝－2.07、－1.98， P<0.05)。BMI与补体C3水平( β＝0.108，95% CI：0.084～0.133)、补体C4水平( β＝0.026，95% CI：0.012～0.039)、白细胞数目( β＝0.433，95% CI：0.166～0.699)、淋巴细胞数目( β＝0.175，95% CI：0.089～0.261)、中性粒细胞数目( β＝0.226，95% CI：0.014～0.438)呈正相关( t＝8.60、3.62、3.18、4.01、2.10， P<0.05)。食用水果( β＝0.017，95% CI：0.001～0.034)与补体C4水平呈正相关( t＝2.10， P<0.05)。 结论:本研究表明该铀矿周围中老年男性居民的炎性指标水平与铀矿开采无明显相关。年龄、吸烟、BMI和食用水果为中老年男性居民炎性指标水平的影响因素。

abstractsObjective:To investigate the inflammatory indicator levels and influencing factors on middle-aged and elderly male residents at different residential distances from a uranium mine in Guangdong, so as to provide scientific data for the health risk assessment of the residents therein.Methods:With stratified sampling method, two groups of the permanent middle-aged and elderly male residents were randomly sampled within < 10 km and 10-20 km of the uranium mine, along with the basic demographic characteristics and lifestyle information collected through face-to-face questionnaire survey. Both height and weight of the respondents were measured using standard method and their body mass indexes (BMI) were calculated. Through collection of the venous blood, the levels of a wide range of inflammatory indicators were measured, such as C-reactive protein (CRP), complement C3, complement C4, leukocytes, lymphocytes, neutrophils, tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and others. Multiple linear regression was used to analyze the influencing factors on the levels of inflammation indicators.Results:A total of 867 middle-aged and elderly male residents were included in this study, including one group of 431 residents within the 10-20 km at an average age of 51.54±5.37, and a second group of 436 residents within <10 km at an average age of 52.05±5.24. The result of multiple linear regression showed a positive correlation of the distance groups with complement C4 level ( β=0.014, 95% CI: 0.001-0.027) and lymphocyte number ( β=0.086, 95% CI: 0.003-0.168) ( t=2.07, 2.04, P<0.05). The ages of middle-aged and elderly male residents around the uranium mine was positively correlated ( t=2.50, P<0.05) with the levels of complement C4 ( β=0.018, 95% CI: 0.004-0.031), and negatively correlated ( t=-3.25, -2.97, P<0.05) with the levels of TNF-α ( β=-63.022, 95% CI: -101.114 to -24.929) and IL-6 ( β=-14.694, 95% CI: -24.396 to -4.992). Smoking was positively correlated ( t=4.29, 4.81, 3.19, P<0.05) with leukocytes number ( β=0.630, 95% CI: 0.341-0.918), lymphocytes number ( β=0.226, 95% CI: 0.134-0.319) and neutrophils number ( β=0.372, 95% CI: 0.143-0.601), and negatively correlated ( t=-2.07, -1.98, P<0.05) with the levels of TNF-α ( β=-43.551, 95% CI: -84.778 to -2.324) and IL-6 ( β=-10.603, 95% CI: -21.103 to -0.102). BMI was positively correlated ( t=8.60, 3.62, 3.18, 4.01, 2.10, P<0.05) with complement C3 level ( β=0.108, 95% CI: 0.084-0.133), complement C4 level ( β=0.026, 95% CI: 0.012-0.039), leukocytes number ( β=0.433, 95% CI: 0.166-0.699), lymphocyte number ( β=0.175, 95% CI: 0.089-0.261), and neutrophil number ( β=0.226, 95% CI: 0.014-0.438). Fruit consumption ( β=0.017, 95% CI: 0.001-0.034) was positively correlated with complement C4 levels ( t=2.10, P<0.05). Conclusions:This study showed no significant correlation between the inflammatory index levels of middle-aged and elderly male residents around the uranium mine and uranium mining. Age, smoking, BMI and fruit consumption were the influencing factors on the levels of inflammatory indicators of middle-aged and elderly male residents.