金华市0～6岁铅暴露儿童血液系统及神经发育状况调查

Investigation on blood system and nerve development of children aged 0-6 years with lead exposure in Jinhua

目的探讨金华市0～6岁铅暴露儿童情况及铅对儿童血液系统和神经系统发育状况的影响。方法采用整群随机抽样法抽取金华市婺城区0～6岁铅暴露儿童243名为暴露组,其中,母亲铅暴露42例为暴露1组,父亲铅暴露119例为暴露2组,父母均未暴露82例为暴露3组,同期非暴露儿童40名为对照组。检测各组儿童血铅(PbB)、尿铅(PbU)、血红蛋白(Hb)、血清铁蛋白(SF)、血清铁(Fe)、叶酸水平,分析儿童智商(IQ)值及注意缺陷多动障碍(ADHD)情况。结果暴露组PbB和PbU水平明显高于对照组(P<0.05),且暴露1组PbB水平明显高于暴露2和3组(P<0.05);暴露组铅中毒率为18.93%,对照组无铅中毒(P<0.05)。暴露组血清中Hb、平均红细胞血红蛋白浓度(MCHC)明显低于对照组(P<0.05),贫血率明显高于对照组(P<0.05);暴露组随着PbB水平升高,Hb和MCHC明显降低(P<0.05),Hb与PbB呈明显负相关(P<0.05)。暴露组儿童IQ评分明显低于对照组,且以暴露1组最低(P<0.05);暴露组ADHD发生率明显高于对照组(P<0.05),以多动冲动型多见。结论铅暴露将增加儿童贫血、智力障碍及ADHD等发生风险。

Objective To investigate the effects of lead exposure in children aged 0-6 years old in Jinhua on the development of blood system and nervous system.Methods A total of 243 children aged 0-6 years with lead exposure were selected by cluster random sampling in Wucheng District,Jinhua.Among them,42 children with lead exposure from their mother were defined as group 1,119 children with lead exposure from their father were defined as as group 2,82 children without lead exposure from their parents were defined as group 3,and 40 children without lead exposure in the same period were selected as the control group.Blood lead(PbB),urine lead(PbU),hemoglobin(Hb),serum ferritin(SF),serum iron(Fe),and folic acid levels of children in each group were detected,and IQ value and attention deficit hyperactivity disorder(ADHD)of children in each group were analyzed.Results PbB and PbU levels in the exposed group were significantly higher than those in the control group(P<0.05),and PbB levels in the group 1 were significantly higher than those in the group 2 and group 3(P<0.05).The lead poisoning prevalence was 18.93%in the exposed group and no lead poisoning in the control group(P<0.05).Hb and MCHC concentrations in serum of the exposed group were significantly lower than those of the control group(P<0.05),and the anemia prevalence was significantly higher than that of the control group(P<0.05).With the increase of PbB level,Hb and MCHC in the exposure group decreased significantly(P<0.05),and Hb was negatively correlated with PbB(P<0.05).The IQ score of the exposed group was significantly lower than that of the control group,and the lowest was found in the group 1(P<0.05).The prevalence of ADHD in the exposed group was significantly higher than that in the control group(P<0.05),and hyperactivity and impulsivity were more common.Conclusions Lead exposure increases the risk of anemia,mental retardation and ADHD in children.