2009年广州地区儿童血铅水平调查

目的调查2009年广州地区儿童血铅水平。方法使用原子吸收光谱法测定2009年本院37318名儿童的血铅水平,并分别对不同年龄和性别的儿童血铅平均水平和铅中毒发生率进行统计分析。结果广州地区儿童血铅总体均值为47.55μg/L;血铅水平≥100μg/L的占2.91%,其中血铅水平在200～249μg/L的占0.25%,血铅水平在250～449μg/L的占0.28%,血铅水平〉450μg/L的仅占0.035%;男童血铅总体均值（49.37μg/L）高于女童（44.28μg/L）。结论 2009年广州地区儿童血铅水平及铅中毒率较往年有所下降。     

大庆地区515例儿童血铅水平检测的结果分析

目的分析大庆市儿童血铅水平,儿童血铅检测的结果分析。方法采用MG2型血液铅铬分析仪检测515例0-12岁儿童血铅水平,对4个年龄组儿童血铅水平应用SPSS12.0软件进行分析。结果不同年龄,不同性别的儿童血铅水平存在显著差异。儿童血铅水平均值为（60.63±12.85）μg/L,男童血铅水平均值为（59.45±11.63）μg/L,女童血铅水平均值为（55.81±5.87）μg/L;其中血铅水平≥100μg/L者72例,铅中毒发生率为13.9%。其中男童45例,铅中毒发生率为14.41%。女童27例,铅中毒发生率为13.41%。儿童血铅水平均值、铅中毒率差异均无统计学意义（P（0.05）;不同年龄段男女儿童血铅水平、铅中毒率有统计学意义（P〈0.05）。结论大庆市0～12岁儿童血铅水平、铅中毒率随年龄增长而升高。男童铅中毒发生率高于女童。     

低水平铅暴露人胎盘组织诱导型和内皮型一氧化氮合酶的表达及意义

目的探讨孕期低水平铅暴露对胎盘组织诱导型和内皮型一氧化氮合酶的表达及其与铅水平的关系。方法2005年2月至2006年12月孕期外周血铅水平大于30μg/l的67例孕妇,根据铅水平分组,血铅水平30μg/l-60μg/l的孕妇35例为A组;血铅水平在60μg/l-100μg/l的孕妇32例为B组。检测胎盘中一氧化氮合酶系统表达。结果低水平铅暴露下诱导型和内皮型一氧化氮合酶在各组胎盘中的表达均分布在合体滋养细胞、细胞滋养细胞、微小血管内皮细胞、蜕膜细胞、绒毛间纤维细胞(villus fibrocyte)的胞浆,定位显示无显著差异;高血铅组的表达水平与强度显著高于低铅水平组(P<0.05)。结论金属铅可诱导发育中胎盘组织诱导型和内皮型一氧化氮合酶产生,胎盘NOS酶活性上升,能够改善子宫-胎盘血循环障碍,抵御铅毒性,维持正常妊娠的进行。     

南京市区170例母乳铅与母血、脐血铅含量的相关性分析

目的了解南京地区产妇母乳含量与母血、脐血铅含量之间的相关性。方法采用石墨炉原子吸收光谱法对南京地区170例产妇抽取母乳与母血、脐血中铅含量进行测定,并进行三者之间的相关性分析。结果母血铅含量为14.87-121μg/L,均值为69μg/L;铅含量为15.42-114.32均值为48.74;母乳铅含量为12.42-99.36μg/L,均值为50.23μg/L。母血铅/脐血铅含量呈正相关（r=0.398,P〈0.05）;母血铅/初乳铅含量呈正相关（r=0.571,P〈0.01）;乳铅/脐血铅含量呈正相关（r=0.489,P〈0.05）。结论脐血铅含量呈正相关,血铅可通过胎盘转运给胎儿,母血铅含量与脐血铅水平及母乳铅水平受母血铅含量影响。     

儿童血铅水平与钙锌铁水平互相关系报道

铅中毒已成为影响儿童健康的重要环境医学问题.铅中毒的概念已经发生了根本性的变化,人们的注意力已转向亚临床型无症状性铅中毒.以往被认为安全的血铅水平已一再被证实对儿童健康有害,儿童铅中毒的标准已从20世纪70年代以前的600μg/L 降为目前的100μg/L,而且发现表明,即使血铅水平降到10μg/L,也不存在任何铅安全阈值.生命早期的铅暴露不仅危害儿童期智能和行为发育,而且对成年后心血管异常、骨质疏松等也有影响.     

新生儿脐带血铅水平及其影响因素的研究

目的了解石家庄市新生儿脐带血铅水平及其相关的影响因素.方法采用石墨炉原子吸收光谱法.于2003年4～6月对在我院产科分娩的98例产妇进行静脉血和脐带血铅含量的测定,并进行家庭社会环境和健康状况问卷调查,分析对脐带血铅水平的影响因素.结果(1)98例脐带血铅平均为49μg/L,≥100μg/L者12例,对应的产妇静脉血铅平均为54μg/L,≥100μg/L者17例.(2)产妇血铅与脐带血铅呈正相关,产妇血铅和孕期被动吸烟、马路上滞留时间是胎儿期铅暴露的危险因素,孕期补铁和补钙是胎儿期铅暴露的保护因素.结论本组新生儿脐带血铅水平与家庭和环境因素有关,由此产生的不利影响应引起重视.     

西安地区1286例孕妇静脉血微量元素血铅检测结果分析

目的铅能通过胎盘,当母亲血铅水平大于50μg/L时,就已经对胎儿产生了影响。笔者通过随机对西安市2010年10～12月份怀孕1～8个月的孕妇静脉血血铅含量的测定。提高人们对低浓度血铅对孕妇造成的危害引起高度重视。方法北京博晖创新光电技术有限公司生产的专门用于临床检测血铅的BH2100原子吸收分光光度仪。结果 1286例孕妇静脉血中大于50μg/L小于100μg/L是98例占7.62%;大于100μg/L小于200μg/L的是2例占0.15%,无轻度、中度、重度铅中毒。结论胎盘对血铅无屏障作用,虽然孕妇血铅的正常值是0-100μg/L,但是有资料表明超过50μg/L,就会对胎儿造成危害。1286例孕妇中血铅值大于50μg/L的占到了7.78%,要足够引起人们的重视。     

大庆地区2087例儿童血铅水平调查分析

目的了解大庆市儿童血铅水平及影响因素,分析其流行规律,及时控制儿童铅中毒。方法用原子吸收光谱分析法,对2087例0-7岁农村、城区儿童进行血铅含量测定。结果2087例儿童中,血铅浓度≥100μg/L有416例,占19．9％,血铅浓度〈100μg／L有1671例,占80．1％。城区儿童共1165例,血铅浓度≥100μg／L有246例,占21．1％。农村儿童共测922例,血铅浓度≥100μg／L有170例,占18．4％。两地区铅中毒比例有明显差异,而且,随着年龄的增长,铅中毒的比例逐渐增高。结论大庆地区儿童血铅水平存在地区差异,并且随着着年龄的增长铅中毒比例逐渐增高。     

珠海地区胎儿铅暴露状况及其影响因素的探讨

目的:了解珠海市人群的胎儿铅暴露水平及其影响因素。方法:在珠海市收集脐带血标本81份,用电感耦合高频等离子体发射光谱仪测定血铅浓度,并以面谈问卷的形式对相应的81名产妇进行了社会环境及家庭生活因素调查。结果:81例脐带血血铅水平呈正态分布,范围在0590μg/L。平均值为150μg/L。脐带血血铅水平超过目前认为的安全界限(100μg/L)占67.9%。研究还发现孕妇居住房屋年代、孕妇居住地、孕期食用罐头食品是胎儿铅暴露的危险因素。多元Logistic回归分析发现,食用罐头食品对脐血铅水平的贡献在考虑了其他掺杂因素的影响后仍有统计学意义。结论:目前珠海市环境铅污染状况可能对胎儿的发育产生不利影响。     

PSD-95参与大鼠孕期铅暴露对子代海马突触影响的实验研究

目的:研究大鼠孕期铅暴露后子代海马突触变化与PSD-95表达改变的相关性,探讨铅暴露损伤学习记忆功能的机制。方法:通过饮用0.02%醋酸铅水溶液建立孕期铅暴露模型,利用原子吸收分光光度仪检测血铅,透射电镜技术检测海马突触密度,蛋白印记技术检测子代大鼠海马组织中VGLUT、VGAT和PSD-95的表达。结果:对照组和铅暴露组雄性21 d大鼠体重分别为(55.73±4.23)g和(56.01±5.97)g,无显著差异(P0.05);对照组与铅暴露组雄性21 d大鼠血铅分别为(10.2±2.1)μg/L和(301.2±34.8)μg/L,血铅水平明显升高(P0.01);对照组与铅暴露组雄性21 d大鼠单位面积突触数目分别为32.79±2.03和23.46±1.97,突触密度明显减少(P0.01);铅暴露后,VGAT的表达量没有明显变化(P0.05),VGLUT和PSD-95的表达量明显减少(P0.01)。结论:PSD-95表达减少引起海马兴奋性突触数目的下降是发育期铅暴露损伤学习记忆功能的可能机制。     

The effect of chelation therapy with succimer on neuropsychological development in children exposed to lead

BACKGROUND: Thousands of children, especially poor children living in deteriorated urban housing, are exposed to enough lead to produce cognitive impairment. It is not known whether treatment to reduce blood lead levels prevents or reduces such impairment. METHODS: We enrolled 780 children with blood lead levels of 20 to 44 microg per deciliter (1.0 to 2.1 micromol per liter) in a randomized, placebo-controlled, double-blind trial of up to three 26-day courses of treatment with succimer, a lead chelator that is administered orally. The children lived in deteriorating inner-city housing and were 12 to 33 months of age at enrollment; 77 percent were black, and 5 percent were Hispanic. Follow-up included tests of cognitive, motor, behavioral, and neuropsychological function over a period of 36 months. RESULTS: During the first six months of the trial, the mean blood lead level in the children given succimer was 4.5 microg per deciliter (0.2 micromol per liter) lower than the mean level in the children given placebo (95 percent confidence interval, 3.7 to 5.3 microg per deciliter [0.2 to 0.3 micromol per liter]). At 36 months of follow-up, the mean IQ score of children given succimer was 1 point lower than that of children given placebo, and the behavior of children given succimer was slightly worse as rated by a parent. However, the children given succimer scored slightly better on the Developmental Neuropsychological Assessment, a battery of tests designed to measure neuropsychological deficits thought to interfere with learning. All these differences were small, and none were statistically significant. CONCLUSIONS: Treatment with succimer lowered blood lead levels but did not improve scores on tests of cognition, behavior, or neuropsychological function in children with blood lead levels below 45 microg per deciliter. Since succimer is as effective as any lead chelator currently available, chelation therapy is not indicated for children with these blood lead levels.     

Environmental exposure to lead and children's intelligence at the age of seven years. The Port Pirie Cohort Study.

BACKGROUND. Exposure to lead in early childhood is thought to result in delayed neuropsychological development. As yet there is little longitudinal evidence to establish whether these effects persist into later childhood. METHODS. We measured IQ scores in 494 seven-year-old children from the lead-smelting community of Port Pirie, Australia, in whom developmental deficits associated with elevated blood lead concentrations had already been reported at the ages of two and four years. Exposure to lead was estimated from the lead concentrations in maternal blood samples drawn antenatally and at delivery and from blood samples drawn from the children at birth (umbilical-cord blood), at the ages of 6 and 15 months and 2 years, and annually thereafter. Data relating to known covariates of child development were collected systematically for each child throughout the first seven years of life. RESULTS. We found inverse relations between IQ at the age of seven years and both antenatal and postnatal blood lead concentrations. After adjustment by multiple regression for sex, parents' level of education, maternal age at delivery, parents' smoking status, socioeconomic status, quality of the home environment, maternal IQ, birth weight, birth order, feeding method (breast, bottle, or both), duration of breast-feeding, and whether the child's natural parents were living together, the relation with lead exposure was still evident for postnatal blood samples, particularly within the age range of 15 months to 4 years. For an increase in blood lead concentration from 10 micrograms per deciliter (0.48 mumol per liter) to 30 micrograms per deciliter (1.45 mumol per liter), expressed as the average of the concentrations at 15 months and 2, 3, and 4 years, the estimated reduction in the IQ of the children was in the range of 4.4 points (95 percent confidence interval, 2.2 to 6.6) to 5.3 points (95 percent confidence interval, 2.8 to 7.8). This reduction represents an approximate deficit in IQ of 4 to 5 percent. CONCLUSIONS. Low-level exposure to lead during early childhood is inversely associated with neuropsychological development through the first seven years of life.     

脐血铅含量与体格发育和智商发育的关系及影响因素分析(英文)

目的探讨在宫内低水平铅暴露状态下,新生儿脐血铅含量与神经行为发育的关系,研究目的是评价脐血铅对孕妇妊娠结局和4岁学龄前儿童的神经发育的影响。课题的研究现场选在南京市妇幼保健院医院产科、新生儿科、儿童保健科门诊。2005年10月至2006年10月共170名孕妇被随机选入我们的研究。所采血液和脐血铅测定使用电感耦合等离子体质谱(ICP-MS)法,106名4岁上面提及孕妇所生的子女被随防,随防率是97.25%。方法通过问卷调查和体格检查分别了解上述儿童的一般状况、生长发育情况。用韦克斯勒氏学龄前儿童智商测量量表测定儿童智商,多元线性回归分析脐血铅和学龄前儿童体格和智商的相关性。同时随机选取南京市妇幼保健院医院产科出生的足月新生儿170例。以脐血铅含量作为新生儿铅暴露的指标,新生儿神经行为(NBNA)发育评分作为效应指标,以脐血铅中位数49.7U/L被分为高低铅组。结果高暴露组在新生儿主动肌张力、原始反射,和神经行为发育总评分上低于低暴露组,差异有统计学意义,在新生儿行为能力、被动肌张力、一般估价上差异无统计学意义。根据智商测定揭示,低铅组的操作智商和言语智商明显高于高铅组(t=2.91,P<0.01;t=5.87,P<0.01)。结论脐血铅水平和与婴儿的早期发育有关,铅可通过脐血造成新生儿的铅接触,对新生儿婴儿早期神经行为发育产生不良影响。随着脐血铅水平的增加,学龄前期儿童总智商评分和操作智商评分下降,妊娠期脐铅暴露水平可能是学龄前期儿童总智商评分和操作智商评分降低的危险因素。     

弱智儿童颜色配对,命名及偏好的实验研究

本研究探讨了7～15岁的弱智儿童的颜色配对颜色命名的能力及颜色偏好的特点。结果表明:(1)三个年级的弱智儿童均能进行正确的同色配对,正确率达91%以上,三年级的弱智儿童的正确率达100%,达到了正常三岁儿童的100%正确率水平;(2)颜色命名的正确率相当于正常4—5岁儿童的发展水平;(3)弱智好班儿童(IQ 在70—50之间)对颜色爱好表现有其规律性,较喜爱鲜艳的颜色,与正常儿童的喜爱基本一致;而弱智差班儿童(IQ 在50—30之间),则没有表现出明显颜色爱好的偏向。     

功能性构音障碍儿童的智力水平和智力结构分析

目的：了解功能性构音障碍(FAD)儿童的智力水平和智力结构情况，探讨FAD与语言发育的关系方法：采用韦氏幼儿智力量表(C-WYCSI)对42例FAD的智力功能进行测试，并与47例正常对照组儿童进行比较；两组儿童表达生语言发育时间的比较采用t检验。结果：FAD组的总智商(FIQ)、言语智商(VIQ)及操作智商(PIQ)均在正常范围，但FIQ、PIQ显著低于对照组；智力结构中动物下蛋(AE)和木块图案(BD)分测量表分及知觉组织因子显著低于对照组；FAD组平均表达性语言发育时间为15个月，对照组为13个月．两组比较存在显著性差异。结论：FAD儿童总的智力水平正常，但PIQ、FIQ落后于正常儿童；FAD儿童存在语言发育延迟现象。     

Dead cattle, lead and child health

This study was carried out as part of a larger interagency investigation in response to concerns about human health following the death of three cattle from lead poisoning in an old lead mining area in Silvermines, Tipperary. Its aim was to screen for lead toxicity in the local child population. Screening consisted of measurement of blood lead concentrations and the completion of questionnaires regarding exposure to lead and general health. Pre-school and primary school children resident in four surrounding district electoral divisions (DEDs) were specifically targeted. One out of 334 (0.3%) children screened had an elevated blood lead concentration. The geometric mean lead concentration was 2.6 microg/dl which is below the intervention lead concentration of 10 microg/dl recommended by the CDC. The mean lead concentration in those aged under three years was statistically significantly higher than in those aged three years and over (3.4 microg/dl vs 2.5 microg/dl; p=0.000581). No specific health problems were identified by the questionnaires. This study concluded that the elevated environmental lead levels which were demonstrated by other agencies involved in this investigation are not currently being transferred to children. It recommends further blood screening of children in the area and ongoing education to minimise the risk of lead toxicity in the area in the future.     

儿童青少年智力的双生子研究

目的 应用双生子法探讨遗传和环境因素对儿童青少年智力影响.方法 采用中国修订版-韦氏儿童智力量表评定6～16岁333对双生子的智力特点.应用结构方程模型分析遗传和环境因素对智力的影响.结果 6～16岁儿童青少年的总智商(intelligence quotient,IQ)遗传度为0.43,其中言语智商(verbal intelligence quotient,VIQ)遗传度为0.37,而遗传因素对操作智商(performance intelligence quotient,PIQ)影响甚小.10～16岁的青少年智力遗传度大于6～9岁的儿童(IQ:0.82 vs 0.00,VIQ:0.80 vs 0.00,PIQ:0.51 vs 0.00).男性的言语智商(0.47)受遗传影响大于女性(0.05);而在男性和女性中,操作智商均主要受共享环境的影响.结论 在儿童青少年时期,总智商和言语智商有中度的遗传度,而共享环境因素对操作智商的影响更大;但智商总分及言语智商和操作智商分测试分在年龄较大的青少年的遗传度都明显高于年龄较小的儿童.     

儿童青少年智力的双生子研究

目的 应用双生子法探讨遗传和环境因素对儿童青少年智力影响.方法 采用中国修订版-韦氏儿童智力量表评定6～16岁333对双生子的智力特点.应用结构方程模型分析遗传和环境因素对智力的影响.结果 6～16岁儿童青少年的总智商(intelligence quotient,IQ)遗传度为0.43,其中言语智商(verbal intelligence quotient,VIQ)遗传度为0.37,而遗传因素对操作智商(performance intelligence quotient,PIQ)影响甚小.10～16岁的青少年智力遗传度大于6～9岁的儿童(IQ:0.82 vs 0.00,VIQ:0.80 vs 0.00,PIQ:0.51 vs 0.00).男性的言语智商(0.47)受遗传影响大于女性(0.05);而在男性和女性中,操作智商均主要受共享环境的影响.结论 在儿童青少年时期,总智商和言语智商有中度的遗传度,而共享环境因素对操作智商的影响更大;但智商总分及言语智商和操作智商分测试分在年龄较大的青少年的遗传度都明显高于年龄较小的儿童.     

儿童青少年智力的双生子研究

目的 应用双生子法探讨遗传和环境因素对儿童青少年智力影响.方法 采用中国修订版-韦氏儿童智力量表评定6～16岁333对双生子的智力特点.应用结构方程模型分析遗传和环境因素对智力的影响.结果 6～16岁儿童青少年的总智商(intelligence quotient,IQ)遗传度为0.43,其中言语智商(verbal intelligence quotient,VIQ)遗传度为0.37,而遗传因素对操作智商(performance intelligence quotient,PIQ)影响甚小.10～16岁的青少年智力遗传度大于6～9岁的儿童(IQ:0.82 vs 0.00,VIQ:0.80 vs 0.00,PIQ:0.51 vs 0.00).男性的言语智商(0.47)受遗传影响大于女性(0.05);而在男性和女性中,操作智商均主要受共享环境的影响.结论 在儿童青少年时期,总智商和言语智商有中度的遗传度,而共享环境因素对操作智商的影响更大;但智商总分及言语智商和操作智商分测试分在年龄较大的青少年的遗传度都明显高于年龄较小的儿童.     

儿童青少年智力的双生子研究

目的 应用双生子法探讨遗传和环境因素对儿童青少年智力影响.方法 采用中国修订版-韦氏儿童智力量表评定6～16岁333对双生子的智力特点.应用结构方程模型分析遗传和环境因素对智力的影响.结果 6～16岁儿童青少年的总智商(intelligence quotient,IQ)遗传度为0.43,其中言语智商(verbal intelligence quotient,VIQ)遗传度为0.37,而遗传因素对操作智商(performance intelligence quotient,PIQ)影响甚小.10～16岁的青少年智力遗传度大于6～9岁的儿童(IQ:0.82 vs 0.00,VIQ:0.80 vs 0.00,PIQ:0.51 vs 0.00).男性的言语智商(0.47)受遗传影响大于女性(0.05);而在男性和女性中,操作智商均主要受共享环境的影响.结论 在儿童青少年时期,总智商和言语智商有中度的遗传度,而共享环境因素对操作智商的影响更大;但智商总分及言语智商和操作智商分测试分在年龄较大的青少年的遗传度都明显高于年龄较小的儿童.