1 253例儿童血铅水平调查分析

目的 了解天门市儿童血铅水平及其影响因素,为控制儿童铅中毒提供依据.方法 用原子吸收光谱分析法对1 253例儿童进行血铅含量测定.结果 1 253例儿童中,血铅浓度≥100 μg/L有182例,占14.53%;血铅浓度＜100 μg/L有1 071例,占85.47%.城区儿童血铅水平高于农村儿童,差异有统计学意义(P＜0.01);大年龄段儿童血铅水平高于小年龄段儿童,差异有统计学意义(P＜0.01).结论 本组儿童铅中毒比例不算高,但随着交通、经济发展对环境的影响,轻度铅中毒仍是危害中国儿童健康的问题.     

上临沂市婴幼儿血铅水平调查

目的 了解临沂市区婴幼儿血铅水平及铅中毒流行状况。方法 在严格质量控制下,对来自临沂市区2034名婴幼儿进行血铅水平凋查。结果 2034名婴幼儿血铅平均水平为69.1 μg/L,其中血铅≥100μg/L者266例,占13.1％;不同性别婴幼儿血铅水平和铅中毒流行率无显著性差异。结论 临沂市婴幼儿血铅水平和铅中毒流行率较高,应该引起足够重视。     

一起铅中毒暴发事件中患儿铁代谢指标检测分析

目的检测不同程度铅中毒患儿和对照组患儿铁代谢指标(铁和铁蛋白)水平,分析当铅中毒时,血铅水平是否会引起铁代谢的异常改变。方法参考1991年美国疾病预防控制中心制定的儿童铅中毒指南将铅中毒儿童分为3组:铅中毒轻度组(100μg/L≤血铅200μg/L)、铅中毒中度组(200μg/L≤血铅450μg/L)、铅中毒重度以上组(血铅≥450μg/L)。并以同期门诊铅中毒筛查中血铅水平正常的25例儿童作为对照组(血铅100μg/L)。分别检测每组儿童血中铅、铁及铁蛋白水平,并对各组结果进行统计分析比较。结果血中铁和铁蛋白水平随铅水平升高而呈降低趋势(P0.001)。相关回归分析结果显示,铅与铁和铁蛋白均呈负相关(r=-0.582、-0.569,P0.001)。结论铅中毒会引起血中铁和铁蛋白水平降低而导致铁代谢异常。     

3621例儿童血铅水平调查

目的调查2009年深圳市妇幼保健院门诊儿童血铅水平和铅中毒状况。方法采用钨舟原子吸收光谱法测定3621例0～12岁儿童血铅水平,对各年龄组儿童血铅值应用SPSS15.0软件进行分析。结果 3621例0～12岁儿童血铅水平为43.58μg/L,按年龄分为4组,组间差异有统计学意义,男、女童血铅水平分别为45.61、41.23μg/L,幼儿前期和小学阶段儿童血铅水平存在性别差异。血铅水平大于或等于100μg/L者130例,铅中毒率为3.59%,铅中毒率最低为婴儿组(2.76%),最高是小学阶段(7.05%);男童铅中毒51例,铅中毒率为4.16%,女童铅中毒49例,铅中毒为2.76%,中毒的比例在男女童间差异具有统计学意义(P0.05)。结论儿童血铅水平及中毒率随年龄增长而增加,男童血铅水平及中毒率均高于女童。     

铅中毒及排铅药物的研究进展

铅是一种不可降解、损害多脏器的重金属环境污染物［1］。随着现代工业与交通的迅猛发展，铅对环境的污染日益严重，严重威胁人类尤其是少年儿童的健康［2］。以往的研究认为血铅浓度超过100μg/L为铅中毒，但近年研究发现［3］，即使血铅浓度低于100μg/L也会对8-15岁儿童的身体（主要是神经系统）产生损害。据我国9省19市3~5岁幼儿血铅水平调查显示，29.9%的幼儿血铅值超标［4］。我国儿童血铅平均值92.9μg/L，有33.8%的儿童血铅水平超过100μg/L［5］，按此比例，我国3.3亿14岁以下儿童中有1.2亿左右受到铅中毒威胁。本文就铅中毒的危害和排铅相关文献做一综述。     

2896例学龄前儿童血铅检测结果的分析

目的 了解学龄前儿童血铅浓度与铅中毒情况.方法 选择2013年钟祥市城区学龄前儿童2 896例,将其按年龄分为2～〈3岁组（n=693）、3～〈4岁组（n=702）、4～〈5岁组（n=726）及5～〈6岁组（n=775）.采用BH2100型原子吸收光谱仪检测儿童血铅浓度.结果 2 896例学龄前儿童血铅浓度为（49.62±20.12）μg/L,其中有393例儿童血铅不低于100 μg/L,占13.57%;不同年龄组间儿童血铅浓度与铅中毒百分比的差异均有统计学意义（P〈0.05）,且随着年龄增长,血铅浓度有上升趋势.不同性别儿童血铅浓度及铅中毒百分比的差异无统计学意义（P〉0.05）.结论 学龄前儿童血铅水平具有随年龄增长而增加的趋势.     

萍乡市3000例儿童血铅水平调查

目的了解萍乡地区0～8岁儿童近期血铅水平及影响因素。方法采用北京博晖光电科技有限公司提供的原子吸收光谱法测定末梢血全血铅含量。结果3000例儿童血铅分析中，平均血铅浓度为64μg／L，血铅浓度高于铅中毒标准100μg／L的人数为360例，铅中毒发生率为12％，铅中毒以轻度为主，中度铅中毒有5例，无重度铅中毒现象。结论萍乡地区近两年儿童铅负荷状况有明显改变，要降低儿童铅中毒的比例，必须从摄食、呼吸空气、个人卫生习惯入手，降低学龄前儿童的血铅水平。     

永嘉县1～6岁儿童血铅水平调查分析

目的 了解永嘉县1～6岁儿童血铅水平现状,为防治儿童铅中毒提供科学依据.方法 2004年5月～2005年12月对永嘉县山区、城镇及经济发达区(工业区)396名1～6岁儿童进行空腹静脉采血1ml,用原子吸收分光光度仪进行血铅水平测定.结果 永嘉县儿童平均血铅含量为(62±30) μg/L,≥100 μg/L的有63例,占15.91%,其中5～6岁儿童血铅平均含量较高.性别、年龄间血铅水平差异均有统计学意义(P＜0.05),但三片区间血铅水平差异无统计学意义(P＞0.05).结论 永嘉县儿童血铅水平超标率明显偏低,但也存在超标情况,仍需高度重视,性别、年龄间存在的差异,在防治时亦应予以重视.     

2009年诸暨市儿童血铅检测回顾性分析

目的通过对本地区儿童血铅检测,了解诸暨市儿童血铅中毒情况,并探讨血铅水平与不同人群的关系。方法用原子吸收光谱分析法对1 895名儿童进行血铅测定,并将受检儿童按年龄（≤3岁、4～6岁、〉6岁）、性别、是否本地分组。结果 1 895名儿童血铅均值为48.63μg/L,其中有198例儿童血铅≥100μg/L,占10.45%。≤3岁组儿童血铅水平及铅中毒率最低,与其他年龄段相比差异有统计学意义（P〈0.05）。4～6岁组与〉6岁组相比血铅水平及铅中毒率均无差异（P〉0.05）。同年龄组男、女儿童血铅水平与铅中毒率均无差异（P〉0.05）。外地组血铅水平及铅中毒率均明显高于本地组（P〈0.05）。结论本地及儿童血铅水平与全国各省相比处于低水平位置,血铅≥100μg/L的发生率与全国平均值相近。儿童血铅水平与年龄有一定关系,男、女差异不大,儿童的卫生习惯、家长重视程度、居住环境、营养状况对血铅水平有一定影响。     

新疆五家渠市学龄前儿童血铅水平调查分析

目的了解新疆五家渠市学龄前儿童的血铅水平,填补本市该领域的数据空白,为进一步研究提供参考,为制订儿童铅中毒防治方案提供科学依据。方法用AS-9000A型高准度微量元素分析仪对该市2 647例1~6岁学龄前儿童进行血铅测定,按血铅水平大于或等于100μg/L为超标,其中大于或等于200μg/L为铅中毒进行评价,对数据进行统计分析。结果 2 647例学龄前儿童血铅水平为(58.79±38.13)μg/L,血铅超标343例,占12.96%,其中达到铅中毒者12例,占调查对象的0.45%;男童血铅水平高于女童;随着年龄增长,血铅水平呈逐渐增高的趋势。结论该市学龄前儿童血铅水平接近国内总体水平,但血铅超标率高于国内总体水平,应高度重视,采取有效措施,降低该市儿童血铅水平。     

Acquired predisposition to mycobacterial disease due to autoantibodies to IFN-gamma

Genetic defects in the IFN-gamma response pathway cause unique susceptibility to intracellular pathogens, particularly mycobacteria, but are rare and do not explain mycobacterial disease in the majority of affected patients. We postulated that acquired defects in macrophage activation by IFN-gamma may cause a similar immunological phenotype and thus explain the occurrence of disseminated intracellular infections in some patients without identifiable immune deficiency. Macrophage activation in response to IFN-gamma and IFN-gamma production were studied in whole blood and PBMCs of 3 patients with severe, unexplained nontuberculous mycobacterial infection. In all 3 patients, IFN-gamma was undetectable following mitogen stimulation of whole blood, but significant quantities were detectable in the supernatants of PBMCs when stimulated in the absence of the patients' own plasma. The patients' plasma inhibited the ability of IFN-gamma to increase production of TNF-alpha by both autologous and normal donor PBMCs, and recovery of exogenous IFN-gamma from the patients' plasma was greatly reduced. Using affinity chromatography, surface-enhanced laser desorption/ionization mass spectrometry, and sequencing, we isolated an IFN-gamma-neutralizing factor from the patients' plasma and showed it to be an autoantibody against IFN-gamma. The purified anti-IFN-gamma antibody was shown to be functional first in blocking the upregulation of TNF-alpha production in response to endotoxin; second in blocking induction of IFN-gamma-inducible genes (according to results of high-density cDNA microarrays); and third in inhibiting upregulation of HLA class II expression on PBMCs. Acquired defects in the IFN-gamma pathway may explain unusual susceptibility to intracellular pathogens in other patients without underlying, genetically determined immunological defects.     

Immunoglobulin administration to fetuses with anemia due to alloimmunization to D

BACKGROUND: The purpose of this study was to examine fetal tolerance of high-dose intravenous immunoglobulin (IVIG), given directly at the time of intravascular transfusion, and its effects on fetal hemolysis and pregnancy outcome in the setting of alloimmunization to D.
STUDY DESIGN AND METHODS: Thirteen consecutive D+ fetuses requiring transfusion for maternal alloimmunization received high-dose IVIG (1.0 g/kg) and red cell transfusions. Twenty-four previous, consecutive fetuses with maternal anti-D served as controls. The schedules for subsequent transfusions were the same in the two groups.
RESULTS: High-dose IVIG was well tolerated by all fetuses. In the IVIG group, daily decreases in hematocrit were smaller than those in controls after the second administration of IVIG (mean hematocrit decrease, 0.72 percent/day vs. 1.45 percent/day; p = 0.007). No significant difference was found in the total number of fetal transfusions, the gestational age at delivery, the duration of neonatal intensive care, the number of neonates requiring postnatal transfusion therapy, and perinatal mortality.
CONCLUSION: In this small pilot study, direct administration to fetuses of IVIG with red cell transfusions was well tolerated and appeared to have a beneficial effect on fetal hemolysis.