上海新华医院铅中毒门诊194例儿童血铅资料的分析

Blood lead analysis of 194 outpatient cases of childhood lead poisoning in Shanghai Xinhua Hospital

目的了解铅中毒儿童的临床症状及主要影响因素,为防治儿童铅中毒提供依据。方法根据知情同意的原则,在上海某三甲医院铅中毒门诊收集194例儿童,填写"铅中毒门诊问卷",评估铅中毒儿童的临床特征及主要污染源。采集儿童静脉血,用石墨炉检测血铅水平。结果 194例儿童的平均血铅水平为(246±146)μg/L,其中男童共116例,女童共78例。年龄为4个月~15岁,其中铅中毒儿童以婴幼儿组为主(x^2=9.124,P<0.0167)。不同家庭情况中,父亲为工人的儿童铅中毒检出率高于父亲非工人的儿童(x^2=4.109,P<0.05)。临床症状上,铅中毒组的儿童厌食及头痛所占比例高于血铅正常组(x^2值分别为4.815、4.699,P<0.05)。经Logistic回归分析,导致儿童铅中毒的高危因素为使用红丹粉、黄丹粉、偏方如密陀僧、铅丹以及居住工业区等(B值分别为2.556、2.162、1.979、1.686,均P<0.05)。结论铅中毒影响儿童生长发育,明确污染源,积极防治儿童铅中毒。

Objective To investigate the major symptoms and influencing factors of lead poisoning in children so as to provide evidence for preventing and curing childhood lead poisoning. Methods According to the principle of informed consent, 194 cases of children with lead poisoning recruited in a third-leveled hospital in Shanghai were analyzed. The lead poisoning outpatient questionnaire was filled to evaluate the clinical features of lead-poisoned children and the major pollution source. Venous blood samples were collected to measure blood lead level by graphite furnace atomic absorption spectrometry. Results Totally 116 boys and 78 girls aged 4 months to 15 years were detected, and their average blood lead level was 246±146μg/L. Infants were the majority in lead poisoning cases （χ^2 = 9. 124, P 〈 0. 0167 ）. Considering father＇ s occupation, kids from worker＇ s family suffered higher risk than those whose fathers were not workers （χ^2 = 4. 109, P 〈 0.05 ）. The proportions of anorexia and headache were higher in lead poisoning group than in normal group （χ^2 value was 4. 815 and 4.699, respectively, both P 〈 0.05）. Logistic regression analysis showed that use of red lead powder, yellow lead power, traditional popular prescriptions such as litharge and red lead, living in the industry areas were the high risk factors （B value was 2. 556, 2. 162, 1. 979 and 1. 686, respectively, all P 〈 0.05 ）. Conclusion Lead poisoning is harmful to children growth. It is important to make the lead poisoning source clear and prevent children from lead poisoning actively.