广西壮族儿童支气管哮喘与铅暴露的关系

Association between Plumbum Exposure and Childhood Asthma in Guangxi Zhuang Autonomous Region

目的探讨儿童铅暴露与支气管哮喘(哮喘)的关系。方法选择2011年2月-2012年2月在百色市妇幼保健院和右江民族医学院附属医院儿童哮喘门诊就诊的哮喘儿童126例。男66例,女60例;年龄2～8(6.0±2.1)岁。根据病情,将哮喘儿童分为轻度发作(69例)、中度发作(33例)和重度发作(24例)。健康对照组选择同期在百色市妇幼保健院和右江民族医学院附属医院儿科体检的健康儿童118例。男60例,女58例;年龄2～9(6.0±2.8)岁。无哮喘及其他呼吸系统疾病,其本人和家族成员无变应性疾病及变态反应性疾病史。采用原子吸收光谱法检测哮喘儿童血铅水平,ELISA法检测其血清总IgE,静脉血常规分类法计数外周血嗜酸性粒细胞(EOS),并与健康对照组比较。结果哮喘儿童组血铅、总IgE及EOS计数均明显高于健康对照组,差异均有统计学意义(Pa<0.001),不同哮喘发作程度患儿血铅、总IgE水平及EOS计数差异均有统计学意义(Pa=0.001),重度发作组血铅、总IgE水平及EOS计数高于中度发作组,中度发作组高于轻度发作组,差异均有统计学意义(Pa<0.001)。哮喘儿童血铅与血清总IgE、EOS计数均呈显著正相关(r=0.879、0.823,Pa<0.01)。结论铅暴露导致与哮喘有关的免疫损伤是引起儿童哮喘高IgE水平并诱发哮喘的重要因素,并可能增加儿童哮喘的发病风险。

Objective To explore the association between plumbum （Pb） exposure and childhood asthma. Methods The study was conducted through case -control method, 126 children with asthma were included [ male/female were 66/60 cases;aged 2 -8 （6.0 ± 2.1 ） years ] and 118 healthy children were selected as controls [ male/female were 60/58 cases;aged 2 -9 （6.0 ± 2.8 ） years ] in the study in Ma- ternal and Child Health Hospital of Baise and the Affiliated Hospital of Youjiang Medical College for Nationalities. According to patients＇ con- ditions, 126 cases were divided into 3 groups ： mild cases （ n = 69 ）, moderate cases （ n = 33 ） and severe cases （ n = 24） ;whereas controls were free from asthma or other respiratory diseases,or allergic diseases in themselves or their family members. Serum Pb, serum total IgE, and pe- ripheral blood eosinophilic （EOS） granulocytes were measured using atomic absorption spectrometry, enzyme linked immunosorbent assay, and routine blood test, respectively. Results The levels of serum Pb and total IgE, and the number of EOS granulocytes in the children with asth- ma were higher than those in the healthy control group,the differences were significant（Pa =0.001 ）. Furthermore,the differences also were observed in the different degrees of asthma：higher serum Pb and total IgE levels,and more EOS granulocytes in severe- degree asthma than those in median- degree asthma or in moderate -degree asthma than those in mild- degree asthma（Pa 〈 0.001 ）. Additionally, the levels of serum Pb were significantly positively correlated with the levels of serum total IgE and the number of peripheral blood EOS granulocytes（ r = 0. 879,0. 823, Pa 〈 0.01 ）. Conclusions Serum Pb, serum total IgE, and EOS granulocytes in the children with asthma are higher than those in the healthy children, and Pb exposure is an important cause of increasing IgE levels in childhood asthma and resulting in asthmatic attacks.