Blood gas analysis as a surrogate for microhemodynamic monitoring in sepsis

BACKGROUND:Emergency patients with sepsis or septic shock are at high risk of death.Despite increasing attention to microhemodynamics,the clinical use of advanced microcirculatory assessment is limited due to its shortcomings.Since blood gas analysis is a widely used technique reflecting global oxygen supply and consumption,it may serve as a surrogate for microcirculation monitoring in septic treatment.METHODS:We performed a search using PubMed,Web of Science,and Google scholar.The studies and reviews that were most relevant to septic microcirculatory dysfunctions and blood gas parameters were identified and included.RESULTS:Based on the pathophysiology of oxygen metabolism,the included articles provided a general overview of employing blood gas analysis and its derived set of indicators for microhemodynamic monitoring in septic care.Notwithstanding flaws,several parameters are linked to changes in the microcirculation.A comprehensive interpretation of blood gas parameters can be used in order to achieve hemodynamic optimization in septic patients.CONCLUSION:Blood gas analysis in combination with clinical performance is a reliable alternative for microcirculatory assessments.A deep understanding of oxygen metabolism in septic settings may help emergency physicians to better use blood gas analysis in the evaluation and treatment of sepsis and septic shock.

An investigation of the effects of dust storms on rat lung using HRCT and blood gas analysis

The increasing intensity and frequency of sand-dust storms in China has led to greater prominence of associated environmentaland health issues. Many studies have focused on the health effects of air particulate contaminants, but fewformal investigations have studied the effects of sand-dust storms on human and animal health. The aim of this study wasto investigate the effects of dust storms on rat lung by using high resolution computed tomography （HRCT） and blood gasanalysis through a wind tunnel simulating. We found that the rat lung damage effects can be detected by the HRCT imagingafter exposure to sand-dust storm environments, but had no obvious result through blood gas analysis. Exposure durationspositively correlated with the damage degree to lung tissue. These will provide some evidence for clinical diagnosis ofnon-occupational pneumoconiosis.

Effects of Hyperventilation on Venous-Arterial Bicarbonate Concentration Difference: A Possible Pitfall in Venous Blood Gas Analysis

Objectives: Recent reports on venous blood gas analysis have shown that venous bicarbonate concentration is useful in the evaluation of the body acid-base status. Most of these reports have been based on the Bland-Altman analysis comparing arterial and venous blood gas values. We intended to elucidate any factors that decrease the agreement between venous and arterial bicarbonate concentrations, which might impair the usefulness of venous blood gas analysis. Methods: Healthy volunteers and patients with various diseases (n = 141) were evaluated by simultaneous arterial and venous blood sampling and Bland-Altman analysis. The venous-arterial bicarbonate concentration difference was compared between healthy volunteers and untreated respiratory alkalosis patients. Intentional hyperventilation (30 or 60 breaths/min, for 3 min) was also performed on 6 healthy volunteers and the venous-arterial bicarbonate concentration difference was evaluated. Results: The relative average bias in bicarbonate concentration was 2.00 mEq/l with venous bicarbonate higher than arterial bicarbonate with 95% limits of agreement of ±4.15 mEq/l. Hyperventilation challenges increased the venous-arterial bicarbonate concentration difference in an intensity-dependent manner. The venous-arterial bicarbonate concentration difference was higher in untreated respiratory alkalosis patients than in healthy volunteers (P Conclusion: Although venous bicarbonate may be useful to evaluate the body acid-base status, hyperventilation increases the venous-arterial bicarbonate concentration difference. Physicians should keep this phenomenon in mind.

Effect of blood gas analysis in patients with bed rest and blood sampling through the dorsal artery:A meta-analysis

Objective:To systematic evaluation by the dorsalis pedis artery puncture for bed patients blood gas analysis of application effect of impact.Methods:A randomized controlled trial of the effect of arterial blood extraction on blood gas analysis in PubMed,CNKI,Wanfang database and VIP database.After selecting the literature,extracting the data and evaluating the quality of the literature.Meta- analysis was carried out by RevMan 5.3 software.Results:Twelve randomized controlled trials were included and 1696 patients were enrolled.After meta-analysis,the arterial puncture can effectively improve the success of arterial puncture in patients with bed [Z = 5.78,95%CI(1.90,3.66),P<0.001],reduce the occurrence of hematoma [Z = 4.27,95%CI(0.19,0.54),P<0.001],reduce the mistaken into the vein [Z = 4.60,95%CI(0.08,0.36),P<0.001],reduce cyanosis [Z = 2.84,95%CI(0.23,0.81),P<0.008],the difference was statistically significant.Conclusion:Dorsalis pedis artery puncture can improve the success rate of blood gas analysis in bedridden patients,reduce the incidence of hematoma and the incidence of venous leakage,and can be widely used in clinical practice.

Effects of Suhuang Zhike Capsule on Pulmonary Function, Blood Gas Analysis Index, Serum PCT and CRP Expression in Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease

OBJECTIVE: To observe the effects of Suhuang Zhike Capsule on pulmonary function, blood gas analysis index, serum PCT and CRP expression in patients with acute exacerbation of chronic obstructive pulmonary disease. METHODS: A total of 88 patients with acute exacerbation of chronic obstructive pulmonary disease admitted to the Department of Respiratory Medicine, Xuancheng People's Hospital of Anhui Province from December 2014 to December 2016 were randomly divided into the observation group and the control group, with 44 cases in each group. The control group was given routine clinical treatment, and the observation group was given Suhuang Zhike Capsule on the basis of the treatment method of the control group. After 7 days' treatment, the improvement of lung function indexes were observed and evaluated before and after treatment(forced expiratory volume in one second(FEV_1), forced expiratory volume occupancy in the 1^(st) second percentage of vital capacity(FEVl/FVC), peak expiatory flow(PEF)), blood gas analysis index(Arterial oxygen partial pressure(PaO_2) and arterial blood carbon dioxide partial pressure(PaCO_2), oxygenation index(OI)) and serum cytokine levels(procalcitonin(PCT) and C reactive protein(CRP). RESULTS: The total effective rate of the observation group was significantly higher than that of the control group(P < 0.05). The FEV_1, FEV_1/FVC and PEF in 2 groups were significantly increased after the treatment(P < 0.05), and the above lung function indexes in the observation group were significantly higher than the control group(P < 0.05). PaO_2 and OI were significantly increased after the treatment(P < 0.05), PaCO_2 was significantly decreased after the treatment(P < 0.05), and the improvement of above blood gas analysis indexes were significantly superior of the observation group than the control group(P < 0.05). The serum PCT and CRP levels in 2 groups were significantly decreased after the treatment(P < 0.05), and the improvement in the observation group were more significant than that in the control group(P < 0.05). CONCLUSION: Suhuang Zhike Capsule can inhibit serum inflammatory cytokine levels in patients with acute exacerbation of chronic obstructive pulmonary disease, improve blood gas analysis indicators, and improve lung functions.

Clinical significance of coagulation function combined with blood gas analysis and serum NT-proBNP detection in COPD patients

Objective:To investigate the clinical significance of coagulation function, blood gas analysis and serum N-terminal pro-brain natriuretic peptide (NT-proBNP) level detection in patients with chronic obstructive pulmonary disease (COPD).Methods: A total of 98 cases of COPD patients were selected and divided per different disease courses. For COPD acute exacerbation (AECOPD) stage, 53 patients were selected and set as group A. 45 cases of COPD patients in COPD stable stage were set as group B, and 50 cases of healthy people who received physical examination in our hospital in the corresponding period were collected and set as healthy controls (group C). Levels of PT, APTT, TT, Fbg, D-D, PaCO2, PaO2 and serum NT-proBNP in the whole 3 groups of patients were detected. Differences of index levels among the 3 groups and between before and after treatment in AECOPD patients were compared separately. The correlations of NT-proBNP, coagulation relevant indexes and arterial blood gas relevant indexes were analyzed.Results: (1) PT, APTT in group A and PT, APTT in group B were obviously longer than which in group C, and group A showed more significant variations. (2) Fbg, D-D, PaCO2, NT-proBNP in group A and Fbg, D-D, PaCO2, NT-proBNP in group B were obviously higher than which in group C;But PaO2 in group A and PaO2 in group B were significantly lower than which in group C;Group A showed more significant variations. (3) After treatment, PT and APTT in AECOPD patients were shorter than which before treatment, Fbg, D-D, PaCO2 and NT-proBNP were lower than before treatment, but PaO2 was higher than before treatment. (4) TT in group A were significantly longer than in group C, and differences showed no significance on comparison of TT between patients of group A and B, B and C and within A before and after treatment. (5) NT-proBNP in COPD patients showed significantly positive correlation separately with APTT, Fbg, D-D and PaCO2, showed significantly negative correlation with PaO2, but showed no obvious correlation with PT.Conclusion: Coagulation function and blood gas analysis combined with serum NT-proBNP level detection could better judge the severity of COPD. It shows significant reference value on clinical diagnosis, disease monitoring and evaluation for COPD patients.

The influence of ganglioside on the blood gas analysis and serum inflammatory cytokines in newborns with anoxic ischemic encephalopathy

Objective:To observe the influence of ganglioside on the blood gas analysis and serum levels of inflammatory cytokines in newborns with anoxic ischemic encephalopathy.Method: A total of 100 newborns with anoxic ischemic encephalopathy in our hospital were selected and randomly divided into 2 groups: the control group and the observation group. Conventional oxygen inhalation, reducing intracranial pressure, controlling eclampsia and neurotrophic drug treatment were given to the observation group. Treatment of ganglioside was given to the control group on the basis of observation group. Blood gas analysis and serum levels of inflammatory cytokines were detected before treatment (T0), 3 d after treatment (T1), and 7 d after treatment (T2).Result: (1) The comparison of pH, PaO2, PaCO2, SaO2 in the two groups in T0 was not statistically significant. The comparison of pH, PaO2, PaCO2, SaO2 in T0, T1, T2 was considered to be statistically significant. Among these, the result of comparision of pH, PaO2, SaO2: T0<T1<T2. comparision of PaCO2: T0>T1>T2. The pH, PaO2, SaO2 in observation group were higher, PaCO2 in observation group was lower compared with that in control group in T1 and T2. The difference was considered to be statistically significant. (2) The comparision of IL-2, IL-6, hs-CRP, TNF-α in the two groups in T0 was not statistically significant. IL-2 in the observation in T1 and T2 was higher than that in the control group, IL-6, hs-CRP, TNF-α in the observation in T1 and T2 was lower than that in the control group. The difference was considered to be statistically significant.Conclusion: Ganglioside can improve blood gas analysis indexes, decrease the serum inflammatory cytokines in newborns with anoxic ischemic encephalopathy.

Effects of terbutaline combined with methylprednisolone on pulmonary function, blood gas analysis and inflammatory factors in patients with chronic obstructive pulmonary disease

Objective: To investigate the effects of terbutaline combined with methylprednisolone on pulmonary function, blood gas analysis and inflammatory factors in patients with chronic obstructive pulmonary disease (COPD). Methods: A total of 100 patients with COPD were randomly divided into control group (n=50) and observation group (n=50) according to the lottery method. Both groups were treated with conventional therapy. On this basis, the control group was given inhalation of terbutaline. The observation group was given terbutaline inhalation and combination therapy with methylprednisolone. The changes of lung function, changes of blood gas analysis and inflammatory factors were measured before and after treatment in both groups. Results: There were no significant differences in lung function between the two groups before treatment. After treatment, the levels of FVC and FEV1 in both groups were significantly higher than those before treatment, and that of the observation group was higher than those of the control group. Before treatment, there was no significant difference between the two groups. After treatment, PaO2 levels in both groups were significantly higher than those before treatment, and that of the observation group was higher than those of the control group. After treatment, PaCO2 levels in both groups were significantly lower than those before treatment, and the observation group was lower than the control group after treatment. There were no significant differences in the levels of inflammatory factors between the two groups before treatment. After treatment, the levels of PCT and TNF-α in both groups were significantly lower than those before treatment, and those of the observation group was lower than those of the control group after treatment. Conclusion: The effect of Terbutaline combined with methylprednisolone treatment of COPD is better, which can significantly improve lung function, stable blood gas analysis, reduce the concentration of inflammatory factors, and be a potential effective treatment programs.

Use of sodium bicarbonate and blood gas monitoring in diabetic ketoacidosis: A review

Diabetic ketoacidosis(DKA) is a severe and toocommon complication of uncontrolled diabetes mellitus. Acidosis is one of the fundamental disruptions stemming from the disease process, the complications of which are potentially lethal. Hydration and insulin administration have been the cornerstones of DKA therapy; however, adjunctive treatments such as the use of sodium bicarbonate and protocols that include serial monitoring with blood gas analysis have been much more controversial. There is substantial literature available regarding the use of exogenous sodium bicarbonate in mild to moderately severe acidosis; the bulk of the data argue against significant benefit in important clinical outcomes and suggest possible adverse effects with the use of bicarbonate. However, there is scant data to support or refute the role of bicarbonate therapy in very severe acidosis. Arterial blood gas(ABG) assessment is an element of some treatment protocols, including society guidelines, for DKA. We review the evidence supporting these recommendations. In addition, we review the data supporting some less cumbersome tests, including venous blood gas assessment and routine chemistries. It remains unclear that measurement of blood gas pH, via arterial or venous sampling, impacts management of the patient substantially enough to warrant the testing, especially if sodium bicarbonate administration is not being considered. There are special circumstances when serial ABG monitoring and/or sodium bicarbonate infusion are necessary, which we also review. Additional studies are needed to determine the utility of these interventions in patients with severe DKA and pH less than 7.0.

Lung ultrasound score evaluation of the effect of pressure-controlled ventilation volume-guaranteed on patients undergoing laparoscopicassisted radical gastrectomy

BACKGROUND Laparoscopic-assisted radical gastrectomy(LARG)is the standard treatment for early-stage gastric carcinoma(GC).However,the negative impact of this proce-dure on respiratory function requires the optimized intraoperative management of patients in terms of ventilation.AIM To investigate the influence of pressure-controlled ventilation volume-guaranteed(PCV-VG)and volume-controlled ventilation(VCV)on blood gas analysis and pulmonary ventilation in patients undergoing LARG for GC based on the lung ultrasound score(LUS).METHODS The study included 103 patients with GC undergoing LARG from May 2020 to May 2023,with 52 cases undergoing PCV-VG(research group)and 51 cases undergoing VCV(control group).LUS were recorded at the time of entering the operating room(T0),20 minutes after anesthesia with endotracheal intubation(T1),30 minutes after artificial pneumoperitoneum(PP)establishment(T2),and 15 minutes after endotracheal tube removal(T5).For blood gas analysis,arterial partial pressure of oxygen(PaO_(2))and partial pressure of carbon dioxide(PaCO_(2))were observed.Peak airway pressure(P_(peak)),plateau pressure(Pplat),mean airway pressure(P_(mean)),and dynamic pulmonary compliance(C_(dyn))were recorded at T1 and T2,1 hour after PP establishment(T3),and at the end of the operation(T4).Postoperative pulmonary complications(PPCs)were recorded.Pre-and postoperative serum interleukin(IL)-1β,IL-6,and tumor necrosis factor-α(TNF-α)were measured by enzyme-linked immunosorbent assay.RESULTS Compared with those at T0,the whole,anterior,lateral,posterior,upper,lower,left,and right lung LUS of the research group were significantly reduced at T1,T2,and T5;in the control group,the LUS of the whole and partial lung regions(posterior,lower,and right lung)decreased significantly at T2,while at T5,the LUS of the whole and some regions(lateral,lower,and left lung)increased significantly.In comparison with the control group,the whole and regional LUS of the research group were reduced at T1,T2,and T5,with an increase in PaO_(2),decrease in PaCO_(2),reduction in P_(peak) at T1 to T4,increase in P_(mean) and C_(dyn),and decrease in Pplat at T4,all significant.The research group showed a significantly lower incidence of PPCs than the control group within 3 days postoperatively.Postoperative IL-1β,IL-6,and TNF-αsignificantly increased in both groups,with even higher levels in the control group.CONCLUSION LUS can indicate intraoperative non-uniformity and postural changes in pulmonary ventilation under PCV-VG and VCV.Under the lung protective ventilation strategy,the PCV-VG mode more significantly improved intraop-erative lung ventilation in patients undergoing LARG for GC and reduced lung injury-related cytokine production,thereby alleviating lung injury.

肝硬化患者血清β2-微球蛋白及动脉血氧变化与Child分级的相关性探讨

目的探讨肝硬化患者血清β2-微球蛋白(β2-MG)及动脉血氧变化与Child分级的关系。方法选取肝硬化患者58例,应用放射免疫法(RIA)检测血清β2-MG水平,应用血气分析仪测定动脉血氧分压(PaO2),并与30例正常献血员血清β2-MG、PaO2水平进行比较。结果肝硬化组血清β2-MG、Child B级高于A级,Child C级明显高于B级,差异有统计学意义;动脉血氧分压从A—B—C级间逐渐下降,低氧血症发生率逐渐升高,Child C级、B级间比较差异有统计学意义。结论提示血清β2-MG与肝功能的损害程度关系密切,PaO2则随着肝功能损害程度加重而逐渐下降,在临床上对肝硬化患者的病情估计及预后判断有一定的指导意义。

A retrospective analysis of the relationship between dermatomyositis-associated interstitial lung disease and disease duration,age,arterial blood gas pH,and serum Cl^(-) levels

Background:Dermatomyositis-associated interstitial lung disease(DM-ILD)represents a severe and insidious complication of dermatomyositis(DM).The study aimed to investigate the association between DM-ILD and arterial blood gas indices,serum ion levels,and the timing of interstitial lung disease onset,with the goal of identifying potential predictors for DM-ILD.Methods:The investigation involved the collection of basic data from 89 patients with DM hospitalized at the Chinese PLA General Hospital between January 2019 and April 2022,and 43 normal control patients hospitalized for physical examinations during the same period.Analyses were conducted to explore the relationship between DM-ILD,arterial blood gas indices,disease duration,and serum ions.A regression model to predict DM-ILD was developed using these indices,and a receiver operating characteristic curve was generated.Results:Significant differences were observed in pH and PaO_(2) between the control group and the disease group(p<0.05).The DM group exhibited higher levels of pH,actual bicarbonate,and base excess(BE)compared with the control group.In contrast,pH and BE levels were lower in the DM-ILD group than in the DM group,with these differences being statistically significant(p<0.05).Interstitial lung disease was correlated with the duration of the disease and pH levels(p<0.05).The cutoff values for age,disease duration,pH,and Cl^(-) were 55.5 years,5.5 years,7.432,and 101.5 mmol/L,respectively.The model demonstrated a prediction sensitivity and specificity for DM-ILD of 0.809 and 0.722,respectively,with an area under the curve of 0.809.Conclusion:Arterial blood gas analysis and serum Cl^(-) levels may assist in predicting DM-ILD.A combined monitoring approach involving arterial blood gas pH,disease duration,age,and serum Cl^(-) levels could enhance the accuracy of DM-ILD predictions and hold significant clinical evaluation potential.

Experimental study on therapy of ultraviolet blood irradiation and oxygenation in acute soman intoxication in rabbits

Objective:To study the therapy effect of ultraviolet blood irradiation and oxygenation （UBIO） on blood AChe activity and lung injury due to acute soman intoxication in rabbits. Methods:Forty rabbits were randomly divided into 4 groups: normal control group, intoxication group, routine therapy group and UBIO therapy group. Blood AChe activity and artery blood gas were analyzed 2 h after intoxication. ACP and AKP activities in BALF were determined respectively. Results:Blood AChe activity in intoxication group was lower than that in normal control group （P<0.05）. BALF ACP and AKP activities in intoxication group were higher than that in normal control group. Blood AChe activities in UBIO therapy group increased and were higher than that in intoxication and routine therapy groups. Compared with intoxication group, BALF ACP and AKP activities were decreased （P<0.05） in UBIO therapy group, while artery blood pH, PaO2 and SaO2 increased （P<0.05）. Conclusion: UBIO therapy can elevate blood AChe activity and alleviate lung injury induced by soman intoxication. So it may be a new way to treat acute soman intoxication.

Algorithm-based arterial blood sampling recognition increasing safety in point-of-care diagnostics

AIM To detect blood withdrawal for patients with arterial blood pressure monitoring to increase patient safety and provide better sample dating.METHODS Blood pressure information obtained from a patient monitor was fed as a real-time data stream to an experimental medical framework. This framework was connected to an analytical application which observes changes in systolic, diastolic and mean pressure to determine anomalies in the continuous data stream. Detection was based on an increased mean blood pressure caused by the closing of the withdrawal three-way tap and an absence of systolic and diastolic measurements during this manipulation. For evaluation of the proposed algorithm, measured data from animal studies in healthy pigs were used.RESULTS Using this novel approach for processing real-time measurement data of arterial pressure monitoring, the exact time of blood withdrawal could be successfully detected retrospectively and in real-time. The algorithm was able to detect 422 of 434(97%) blood withdrawals for blood gas analysis in the retrospective analysis of 7 study trials. Additionally, 64 sampling events for other procedures like laboratory and activated clotting time analyses were detected. The proposed algorithm achieved a sensitivity of 0.97, a precision of 0.96 and an F1 score of 0.97.CONCLUSION Arterial blood pressure monitoring data can be used toperform an accurate identification of individual blood samplings in order to reduce sample mix-ups and thereby increase patient safety.

长春市某医院儿童铅暴露现状及影响因素调查

目的了解长春市儿童铅暴露现状及影响因素,为本地区儿童铅中毒防治工作提供科学依据。方法以长春市某儿童医院儿童保健科在2017年5月—2018年9月收治的804例就诊儿童作为研究对象,进行血铅检测和问卷调查,分析儿童铅暴露的特点。结果长春市儿童血铅水平为32.30(25.40,41.00)μg/L,男童和女童的血铅水平分别为33.00μg/L、32.00μg/L。其中53例血铅水平≥100μg/L,高血铅检出率为6.59%(高铅血症34例、轻度铅中毒7例、中度铅中毒11例、无重度铅中毒例数)。血铅正常组与异常组儿童在性别、父亲文化水平、啃指甲方面比较,差异无统计学意义(P>0.05);但在年龄、母亲文化水平、居住楼层、饭前洗手、吮吸手指、异食癖方面比较,差异有统计学意义(P<0.05)。儿童血铅异常的多因素分析显示:居住楼房较高、饭前洗手等是儿童血铅异常的保护因素(P<0.05);儿童年龄低、吮吸手指、异食癖是儿童血铅异常的危险因素(P<0.05)。结论长春市儿童的血铅水平及高铅血症不容忽视,尤其是3岁及以下婴幼儿、不良行为习惯和异食癖与血铅水平有密切关系。

Effects of nursing team communication and collaboration on treatment outcomes in intensive care unit patients with severe pneumonia

BACKGROUND Severe pneumonia is a common severe respiratory infection worldwide,and its treatment is challenging,especially for patients in the intensive care unit(ICU).AIM To explore the effect of communication and collaboration between nursing teams on the treatment outcomes of patients with severe pneumonia in ICU.METHODS We retrospectively analyzed 60 patients with severe pneumonia who were treated at the ICU of the hospital between January 1,2021 and December 31,2023.We compared and analyzed the respiratory mechanical indexes[airway resistance(Raw),mean airway pressure(mPaw),peak pressure(PIP)],blood gas analysis indexes(arterial oxygen saturation,arterial oxygen partial pressure,and oxygenation index),and serum inflammatory factor levels[C-reactive protein(CRP),procalcitonin(PCT),cortisol(COR),and high mobility group protein B1(HMGB1)]of all patients before and after treatment.RESULTS Before treatment,there was no significant difference in respiratory mechanics index and blood gas analysis index between 2 groups(P>0.05).However,after treatment,the respiratory mechanical indexes of patients in both groups were significantly improved,and the improvement of Raw,mPaw,plateau pressure,PIP and other indexes in the combined group after communication and collaboration with the nursing team was significantly better than that in the single care group(P<0.05).The serum CRP and PCT levels of patients were significantly decreased,and the difference was statistically significant compared with that of nursing group alone(P<0.05).The levels of serum COR and HMGB1 before and after treatment were also significantly decreased between the two groups.CONCLUSION The communication and collaboration of the nursing team have a significant positive impact on respiratory mechanics indicators,blood gas analysis indicators and serum inflammatory factor levels in the treatment of severe pneumonia patients in ICU.

血中金属元素含量与儿童智力的相关性分析

目的研究血铅、镉、钙、锌、铜5种元素对儿童智力的影响及其关联程度。方法采用分层抽样方法，抽取安徽省池州市某区4～7岁儿童共214名。用中国-韦氏儿童智力量表（C-WYCSI）对儿童进行智力测试和问卷调查（家长用）；采集指血214份，运用PE-AA800原子吸收光谱仪进行血铅、镉、钙、锌、铜5种元素检测。结果血铅与血镉之间存在相关性，钙、锌、铜3种元素间分别存在着相关性；高血铅组儿童操作智商（PIQ）和总智商（TIQ）得分显著低于正常血铅组儿童，高血镉组的TIQ和言语智商（VIQ）得分显著低于正常血镉组得分（P〈0．05）；儿童血铅水平与PIQ（β=-0．138）间存在负相关（P〈0．05），血镉水平与VIQ（β=-0．120）和TIQ（β=-0．110）得分间均存在负相关。儿童血锌与知识（β=0．169）、血钙与领悟（β=0．263）得分存在正相关（P值均〈0．05）。结论血铅、镉对儿童智商有严重的负面影响，而钙、锌则对儿童智力发育起到保护和促进作用。

高氟区儿童血清骨钙素与降钙素含量测定

目的探讨长期饮用高氟水对儿童血清骨钙素和降钙素含量的影响,为儿童氟斑牙的相关研究提供参考依据。方法依据水氟浓度选择高氟区和对照区,随机抽取8～12岁儿童88名进行健康体检,其中高氟区儿童62名,对照区26名。检查氟斑牙患病情况;采集空腹静脉血,应用放射免疫法测定血清骨钙素(BGP)和降钙素(CT)水平。结果高氟区儿童血清BGP含量为(6.77±3.87)ng/L,对照区为(3.78±1.80)ng/L,两者差异有统计学意义(P<0.05)。高氟区儿童血清CT含量为(492.00±526.70)ng/L,对照区为(948.57±747.23)ng/L,两者差异有统计学意义(P<0.05)。高氟区氟斑牙患者、非患者与对照组相比,血清BGP水平和CT水平差异均有统计学意义(P值均<0.05);高氟区氟斑牙患者与非患者BGP及CT水平差异无统计学意义(P>0.05)。结论长期饮高氟水会影响儿童骨代谢。应采取有效措施,降低高氟区居民饮用水的氟含量。

某地区3～6周岁健康儿童干湿化学分析仪6个血清酶项目参考区间的建立与比较研究

目的建立和比较深圳地区3～6周岁健康儿童干湿化学分析仪6个血清酶项目的参考区间,更好地为临床诊断和治疗服务。方法采用随机分层抽样筛选出391名健康儿童抽取静脉血,用美国强生Vitros 350干式化学分析仪和美国Beck-man Coulter LX20湿化学分析仪进行血清天冬氨酸氨基转移酶(AST)、乳酸脱氢酶(LDH)、丙氨酸氨基转移酶(ALT)、碱性磷酸酶(ALP)、γ-谷氨酰转肽酶(GGT)、肌酸激酶(CK)检测并分析结果。结果该地区3～6周岁健康儿童两种方法内不同性别血清AST、LDH、ALT、ALP、GGT结果比较,差异均无统计学意义(P>0.05);CK结果差异均有统计学意义(P<0.05);6个血清酶项目两种方法间结果比较,差异均有统计学意义(P<0.05)。结论 6个血清酶项目两种方法间结果比较均有显著性差异,应该针对不同方法学分别建立该地区3～6周岁健康儿童干湿化学分析仪的参考区间。

血铅水平与儿童注意力及行为的相关研究

目的探讨不同血铅水平儿童的注意力及行为,为临床防治提供参考依据。方法按照中华预防医学会儿童保健分会制定的儿童期铅污染及损害防治常规,按不同血铅水平将2001-2005年江西省儿童医院儿保门诊健康检查的189名学龄儿童分为4级(1级,2-A级,2-B级,3级)进行比较。用多动-注意力障碍诊断量表及Rutter儿童行为量表及视觉激发电位仪,分别对4组儿童进行测试。结果2-A级以上(轻度以上)铅中毒即可对儿童行为产生影响,发生行为障碍或注意力缺陷多动障碍,各组之间差异有统计学意义(P<0.01),且以攻击性行为及注意力缺陷型多见。3级血铅水平儿童神经症行为增加,与其他组之间比较差异有统计学意义(P<0.05)。结论轻度以上铅中毒可导致儿童行为问题的出现,提示对有攻击性行为、多动注意力障碍等行为问题的儿童应做血铅测试,尽早采取防治措施。