沈阳市儿童尿镉水平的流行病学调查

Epidemiological survey of urinary Cadmium in Shengyang urban children

目的 了解沈阳市健康儿童体内镉负荷水平，并初步分析其对儿童肾脏的影响。分析生活因素对体内镉水平的影响，为少儿卫生提供指导建议。方法 采用整群随机抽样法，从沈阳市随机抽取0～17岁健康儿童1170例，按年龄段将入选儿童分为3组（0～5岁组，6～11岁组，12～17岁组），统一进行问卷调查。留取晨起中段尿检测尿常规、尿微量清蛋白、尿α1微球蛋白及尿镉。结果 1.共1070例进入分析，男544例，女526例。2.尿镉随年龄增长而升高，经尿比重校正的尿镉也随年龄的增长而升高，经尿肌酐校正的尿镉随年龄增长而降低。3.经尿肌酐校正后的尿镉与尿微量清蛋白呈正相关（rs=0.45，P 〈0.01）。4.沈阳市儿童尿镉的参考值范围：0～5岁〈0.56 μg/L，6～11岁〈0.65 μg/L，12～17岁〈0.74 μg/L。经尿比重校正的尿镉参考值范围：0～5岁〈0.83 μg/L；6～11岁〈1.01 μg/L；12～17岁〈1.15 μg/L；经尿肌酐校正的尿镉的参考值范围：0～5岁〈2.17 μg/gCr；6～11岁〈1.23 μg/gCr；12～17岁〈1.25 μg/gCr。结论 沈阳市儿童尿镉水平随年龄增长而增高，目前未造成肾损害，但应尽可能减少镉的摄入，并加强对儿童镉负荷水平的跟踪研究。

Objective To evaluate the body burden of Cadmium（Cd） in normal children from Shenyang city, and to analyze the effect of Cd on kidney. Furthermore, to investigate the influences of living factors on the level of Cd in children, so as to make recommendations for children＇s health. Methods The subjects was composed of 1170 healthy children recruited from 0 to 17 years old by cluster random sampling method. They were divided into three groups（0 - 5 years old group ,6 - 11 years old group, 12 - 17 years old group）. Questionnaires were used to obtain essential information about age, gender, weight, socioeconomic status, medication, and so on. Second morning urine samples were collected to make routine analyses, urinary Cd（Cdob） , urine microalbumin（ MALB ） and αl-microglobulin （α1-MG）. Results 1. A total of 1070 children including 544 males and 526 females were enrolled. 2. The concentration of Cdob increased with age, in agreement with the level of urinary Cd corrected by urine specific gravity （Cdsg）. However, the level of Cd in urine corrected by urinary ereatinine（Cder） presented the opposite status with the age increasing. 3. Cdcr and urine MALB adjusted by urinary creatinin（MALBcr） revealed a positive correlation（ rn = 0.45, P 〈 0.01 ）. 4. Preference values for Cdob and Cdsg,Cdcr respectively were：0 - 5 years old 〈0.56 μg/L, 〈0.83 μg/L and 〈2.17 μg/g Cr;6-11 years old 〈0.65μg/L, 〈1.01 μg/L and 〈1.23 μg/g Cr;12 -17 years old 〈0.74 μg/L, 〈1.15 μg/L and 〈 1.25 μg/g Cr. Conclusions There is an age-dependent cumulative increases in Cdob. Although renal damage was not found in this study,the uptake of Cd should be reduced as much as possible and it is necessary to strengthen the follow-up study of Cdob in body burden.