纸片法筛查儿童铅中毒的可行性研究

Feasibility of a filter paper method for screening of childhood lead poisoning

目的 建立一种简便、快速、经济、符合我国国情的儿童铅中毒筛查方法。方法 在纸片法检测血铅的方法已经建立的基础上 ,选择 15 8例 1～ 7岁的儿童 ,同时采集静脉血和手指末梢血进行血铅分析 ,以鉴定两种检测方法的相关性。结果 15 8例静脉血和末梢血纸片法血铅浓度的相关系数达 0 86 89,P <0 0 1。以静脉血铅 10 0和 2 0 0 μg/L为标准 ,纸片法的阳性率分别为 87 3%和10 0 % ;假阴性率分别为 15 3%和 0 ;假阳性率分别为 7 7%和 0。结论 末梢血纸片法筛查儿童铅中毒是可行的 ,在采血过程中避免污染 。

Objective Early screening for childhood lead poisoning and intervention in time is an important method to prevent poisonous effect of lead During the 1990′s, there were two screening tests abroad, which use venous blood sample and capillary blood sample collected on filter paper While in China, only the former method is used for detection of blood lead level It is relatively difficult and inconvenient to collect and transport venous blood specimens In order to establish a new method which is convenient, rapid, inexpensive and suitable for our national condition, we carried out a study on filter paper method for screening of childhood lead poisoning from December 1997 to June 1998 Methods The filter paper selected was Schleicher & Shuell 903 Totally 158 paired venous and capillary blood (FP samples) from children 1 to 7 years of age were analyzed by using a graphite furnace atomic absorption spectrometric micro method Results The 158 paired venous and capillary blood (FP) samples were analyzed for lead levels Comparison of the two sets of results gave a correlation coefficient of 0 868 9 The filter paper results relative to reference method were calculated at levels of 100 and 200 μg/L with positive rates 87 3% and 100%; false negative rates were 15 3% and 0; false positive rates were 7 7% and 0 Conclusion The filter paper method for screening of childhood lead poisoning was accurate and stable, we may substitute it for venous blood collection The key point to assure the test results is to prevent contamination during the blood sample collection The places and tables used for collecting samples should be clean The clients′ fingers must be first washed and cleaned according to the operating procedure The center of the filter paper is not allowed to be touched by substances other than sample blood Puncture must be done into proper depth after the finger becomes dry The proper diameter of blood samples on filter papers is 0 9 to 1 0 centimeter Blood spots can not be merged