广东江门地区3月龄婴儿血铅与乳母血铅及乳铅等因素的相关性研究

Correlation of Lead Levels in 3-Month Old Infant Blood,in Maternal Blood and Breast Milk in Jiangmen City,Guangdong Province

目的：了解广东省江门地区3月龄婴儿血铅与乳母血铅、乳铅等的相关关系，寻找影响婴儿血铅水平的高危因素。方法：采用横断面描述性人群调查方法，对2005年1～4月在广东省江门市新会区妇幼保健院出生的纯母乳或者混合喂养的新生儿在3月龄时分别进行婴儿血铅、乳母血铅与乳铅的测定。并结合其出生时脐带血铅水平，综合评价婴儿血铅的相关影响因素。结果：婴儿3月龄时血铅水平（49．53±23．6μg／L）与其对应的脐血铅水平（49．70±23．77μg／L）比较无显著性差异（P〉0．05）；但是两者均明显低于婴儿3月龄时乳母血铅水平（59．24±28．71μg／L）而高于此时的乳铅水平（26．77±13．70μg／L）（P均〈0．05）；而乳铅水平也明显低于同时采集的乳母血铅水平（P〈0．05）。Spearman偏相关分析显示，婴儿3月龄血铅水平与出生时脐带血铅水平（Spearman偏相关系数rs=0．39，P〈0．01）、乳母血铅水平（rs=0．42，P〈0．01）以及乳铅水平（rs=0．31，P〈0．01）均存在显著的正相关关系。多元回归分析显示，在校正了居住地点、铅接触史、性别等因素的影响后，母乳血铅每变化1μg／L，可相应引起婴儿血铅约14μg／L的变化。结论：乳母血铅及乳铅可明显影响3月龄婴儿血铅水平；乳铅的定量测定和分析，对儿童早期铅暴露的防治具有重要意义。

Objective： To understand the correlation of blood lead levels in 3 - month old infant, in maternal blood and breast milk and to explore the high risk factor effecting blood levels of infant. Method： A cross- sectional descriptive study was carried out among normal 3 -month old infant with exclusive lactation or partial lactation born in Maternal and Child Health, Xinhui District, Jiangrnen City, Guangdong Province from January to March April, 2005. The lead levels of infant blood, maternal blood and breast milk were measured respectively and the related factors influencing infant blood lead levels were analyzed. Result： No significant difference was observed between lead levels in infant blood （49.53 ±23.6 μg/L） and in cord blood （49.70±23.77 μg/L） （P 〉 0.05） which were both lower than that in maternal blood （59.24 ±28.71 μg/L） （P〈 0.05） but higher than that in breast milk （26.77 ±13.70μg/L） （P〈 0.05）. Partial correlation analysis showed the blood lead level of 3 - month old infant was positively associated with lead levels in cord blood, maternal blood and breast milk respectively （Spearman coefficient of partial correlation = 0.39, 0.42 and 0.31 respectively, P 〈 0.01 ）. The multiple regression analysis showed that after the adjustment of habitation, history of lead contact, sex etc, every increase of breast milk in 1 μg/L unit resulted in the increase of blood lead of infant by 14 μg/L. Conclusion： There were significant effect of lead levels in maternal blood and breast milk on the lead levels in 3 - month old infant blood and the quantitative assay and analysis of lead in breast milk was very important for the prevention and cure of the children early exposure to lead.