佩戴镍铬合金烤瓷冠对尿镍铬水平影响的前瞻性随访研究

目的探讨镍铬合金烤瓷冠的佩戴是否会导致机体尿镍铬水平升高。方法对33例镍铬合金烤瓷冠佩戴者进行佩戴前和佩戴2月后的尿镍和尿铬重复测量,并采用配对t检验和重复测量数据线性回归分析探讨尿镍铬水平的变化与镍铬合金烤瓷冠佩戴的关系。结果镍铬合金烤瓷冠佩戴2月后,机体尿镍水平（67.6 μg·mol-1肌酐）略高于佩戴前（46.4 μg·mol-1肌酐）,但差异无统计学意义（P=0.063）;女性患者佩戴前为44.8 μg·mol-1肌酐,佩戴后为73.7 μg·mol-1肌酐（P=0.068）。佩戴2月后,机体尿铬水平（99.4 μg·mol-1肌酐）明显高于佩戴前（57.0 μg·mol-1肌酐）（P=0.024）,这种差异仅在女性中明显（佩戴前为59.8 μg·mol-1肌酐,佩戴后为124.4 μg·mol-1肌酐,P=0.023）。重复测量数据的线性回归分析显示机体尿镍铬的排泄与是否佩戴镍铬合金烤瓷冠、佩戴数量及金属裸露面积有关。结论镍铬合金烤瓷冠的佩戴可导致机体尿镍和尿铬水平增加。

A prospective follow-up study on the impact of urinary excretions of nickel and chromium after dental restoration by nickel-chromium based alloys

Objective To explore whether the dental restoration of nickel-chromium(Ni-Cr) based alloys will lead to extra excretions of urinary Ni and Cr.Methods Urinary Ni and Cr were repeatedly measured in 33 patients before and 2 months after the dental restoration of Ni-Cr alloys.The associations between alloy restoration and urinary Ni or Cr were analyzed by paired t test and general linear model of repeated measures.Results A slightly higher urinary Ni was found in patients after 2 month of the alloy restoration,but the difference was not statistically significant(before: 46.4 μg·mol-1 crea;after: 67.6 μg·mol-1 crea;P=0.063).This difference was only in female subjects(before: 44.8 μg·mol-1 crea;after: 73.7 μg·mol-1 crea;P=0.068).A significant higher urinary Cr was found in patients after 2 month of the alloy restoration(before: 57.0 μg·mol-1 crea;after: 99.4 μg·mol-1 crea;P=0.024).This significant difference was only in female subjects(before: 59.8 μg·mol-1 crea;after: 124.4 μg·mol-1 crea;P=0.023).General linear models of repeated measurements showed that urinary excretions of Ni and Cr were associated with the number of restoration and the area of metal basis uncovered with porcelain.Conclusion Dental restoration of Ni-Cr alloy might lead to the enhanced excretions of urinary Ni and Cr.