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投稿时间：2020-03-21 网络发布日期：2020-12-20
投稿时间：2020-03-21 网络发布日期：2020-12-20
中文摘要: 目的 观察不同血铅水平在1～10岁儿童各年龄段的分布情况，探讨不同血铅值对儿童血红蛋白分布及脑诱发电波的影响。方法 选取2016年9月至2019年9月行入托体检及因疾病门诊就诊的儿童1 020例，检测其血铅水平，分析血铅水平在其各年龄段分布，并按血铅水平分为<50 μg/L组、50～100 μg/L组、>100 μg/L组，观察三组儿童红细胞游离原卟啉(FEP)、血红蛋白(Hb)、平均红细胞血红蛋白浓度(MCHC)水平及皮质体感诱发电位(SEP)、事件相关电位水平。结果 血铅水平≥50 μg/L的儿童占所研究儿童的23.0%，其中以50～100 μg/L最多，4～6岁年龄段的儿童占比最大。血铅水平>100 μg/L组FEP明显高于50～100 μg/L组及<50 μg/L组，Hb、MCHC则明显较其他两组低(P<0.05);血铅水平50～100 μg/L组FEP明显高于<50 μg/L组，Hb、MCHC则明显低于<50 μg/L组(P<0.05)。与晚期皮质电位相关的N35、P45及N60波在>100 μg/L组明显高于<50 μg/L组(P<0.05)，50～100 μg/L组略高于对照组，但差异无统计学意义(P>0.05)。血铅水平>100 μg/L组事件相关中位的N200及P300潜伏期明显高于<50 μg/L组，N200及P300波幅明显低于<50 μg/L组(P<0.05)。结论 血铅水平在50～100 μg/L范围主要分布于4～6岁年龄段，并且此范围血铅水平对儿童Hb合成有影响，并且对部分儿童神经系统及认知能力产生影响。故当儿童血铅水平在50～100 μg/L时就应引起临床重视。
Abstract:Objective To observe the distribution of different blood lead levels in children aged 1-10 years, and to investigate the effects of different blood lead levels on hemoglobin distribution and brain evoked waves in children. Methods A total of 1 020 children who received physical examination and outpatient treatment for diseases from September 2016 to September 2019 were selected to detect their blood lead levels and analyze the distribution of blood lead levels in different age groups.According to different blood lead levels, the children were divided into<50 μg/L group, 50-100 μg/L group and>100 μg/L group.The levels of free erythrocyte protoporphyrin (FEP), hemoglobin (Hb), mean corpuscular hemoglobin contentration (MCHC), somatosensory evoked potential (SEP) and event-related potential were observed. Results 23.0% of the children studied had blood lead level≥50 μg/L, among them, the range of 50-100 μg/L was the most, and the proportion of children aged 4-6 years was the highest.FEP in the blood lead level>100 μg/L group was significantly higher than that in 50-100 μg/L group and<50 μg/L group, while Hb and MCHC were significantly lower than those in the other two groups (P<0.05).FEP in the 50-100 μg/L group was significantly higher than that in<50 μg/L group, while Hb and MCHC were significantly lower than those in<50 μg/L group (P<0.05).The levels of N35, P45 and N60 related to late cortical potentials were significantly higher in>100 μg/L group than those in<50 μg/L group (P<0.05), while those were slightly higher in the group of 50-100 μg/L than in the control group without significant difference (P>0.05).The latencies of N200 and P300 of the event-related in blood lead level>100 μg/L group was significantly higher than those in<50 μg/L group, and the amplitude of N200 and P300 were significantly lower than those of<50 μg/L group (P<0.05). Conclusion The blood lead level of 50-100 μg/L mainly distributed in the age group of 4-6 years old.The blood lead level in this range has an impact on the synthesis of hemoglobin in children, as well as on the nervous system and cognitive ability of some children.Therefore, when the blood lead level of children is in the range of 50-100 μg/L, clinical attention should be paid.
keywords: Blood lead Hemoglobin Erythrocyte free protoporphyrin Brain evoked wave Cortical somatosensory evoked potential Event-related potential
文章编号： 中图分类号：R729，R446.11 文献标志码：A
基金项目:广州市医药卫生科技项目(20151A010077)
| Author Name | Affiliation |
| RAO Xiao-lin, MAI Jing-yi, SU Guang-hui, ZENG Bi-yi | Department of Pediatrics, Guangzhou 12th People′s Hospital, Guangzhou, Guangdong 510620, China |
引用文本：
饶晓林，麦静仪，苏光辉，曾碧仪.儿童血铅水平测定及其对血红蛋白和脑诱发电波的影响[J].中国临床研究,2020,33(12):1635-1638.
饶晓林，麦静仪，苏光辉，曾碧仪.儿童血铅水平测定及其对血红蛋白和脑诱发电波的影响[J].中国临床研究,2020,33(12):1635-1638.