Conners量表在儿童铅暴露与行为效应研究中的应用

Application of Conners Rating Scales in the study of lead exposure and behaviora l effects in children

目的 寻找反映个体长期铅暴露水平的指标及特异的行为效应指标。方法 选取铅工业污染区 1～ 4年级学生 98名为暴露组 ,非污染区学生 10 0名为对照组 ,测定血铅、发铅、锌卟啉以评估铅暴露水平 ,采用高效液相色谱法 电化学法联检测定尿中高香草酸和香草扁桃酸的浓度 ,采用Conners量表评定铅暴露儿童的行为效应。结果 暴露组血铅、发铅和锌卟啉水平增高 ,分别平均为2 39～ 2 42 μmol/L ,81 81～ 83 77μmol/kg和 0 5 5～ 0 6 5 μmol/L ;暴露组尿中高香草酸和香草扁桃酸水平降低 ,分别平均为 0 5 3mmol/mol肌酐和 0 6 8mmol/mol肌酐 ,与对照组相比差异均有非常显著性意义 ;两组行为因子得分差异有显著性意义 ;女性儿童发铅与父母用量表中品行问题、冲动 多动、多动指数之间 ,锌卟啉与父母用量表中因子品行问题、学习问题、冲动 多动、多动指数之间均存在正相关关系。结论 Conners量表可用于铅暴露儿童行为效应的评定 ,而发铅和血铅可以作为反映儿童铅暴露水平的良好标志物。

Objective To seek specific indices reflecting individual level of long-term exposure to l ead and its behavioral effects. Methods Ninety-eight children of grades one to four in primary schools in the areas polluted by lead were chosen as exposed group and 100 children from areas without lead pollution as control group. Levels of blood lead, hair lead and blood zinc protoporphyrin (ZPP) in both groups were determined to evaluate their exposure to lead. Their u rinary homovanillic acid (HVA) and vanillylmandelic acid (VMA) were determined b y a method combined high-performance liquid chromatography (HPLC) with electric chemistry (EC) technique. Behavioral effects in children exposed to lead were a ssessed by Conners′ Rating Scales for Teachers and Parents. Results Levels of blood lead，hair lead and blood ZPP in the ex posed group increased to 2.39～2.42 μmol/L，81.81～83.77 μmol/kg and 0.55～0.6 5 μmol/L in average, respectively, and levels of HVA and VMA decreased to 0.53 mmol/mol creatinine and 0.68 mmol/mol creatinine in average, respectively, both with a very significant difference as compared with those in the control group. There were significant differences in the scores of behavioral factors between t he two groups. Factors Ⅰ, Ⅳ and Ⅵ in Conners ′ Parents′ Rating Scales corre lated positively with levels of hair lead，while factors Ⅰ, Ⅱ, Ⅳ and Ⅵ corre lated positively with blood ZPP levels in girls. Conclusion Con ners ′ Rating Scales for Teachers and Parents can be use d to assess their behavioral effects in children, and levels of hair lead and bl ood lead can be used as good markers to reflect level of exposure to lead in chi ldren.