舟山群岛新生儿脐带血汞暴露水平及影响因素研究

目的了解舟山群岛新生儿脐带血汞暴露水平及影响因素。方法选择2012年6月—2013年7月进行围产保健并住院分娩的舟山户籍孕产妇及其新生儿为研究对象,对孕产妇全血和新生儿脐带血进行汞含量检测,问卷调查新生儿家庭社会环境与健康状况。结果共检测3 052名孕妇全血及其新生儿脐带血汞水平,孕妇血汞平均为(5.33±3.69)μg/kg,中位数为4.63μg/kg,P25~P75为2.8~8.2μg/kg。新生儿脐带血汞含量平均为(7.72±4.87)μg/kg,中位数为7.31μg/kg,P25~P75为4.7~11.2μg/kg。单因素分析提示新生儿脐血汞与母亲孕期吃马鲛鱼有关联(OR=1.79,P0.01),而与新生儿性别,母亲孕期补维生素、补钙、补铁、修补牙齿个数,母亲经常使用皮肤增白化妆品,孕期每月吃鱼及海产品次数及父亲每天吸烟、家庭月平均收入、在本地居住时间等均无关联。经多因素Logistic回归分析显示,脐血汞值与母亲孕期吃马鲛鱼存在关联(OR=1.96,P0.01)。结论舟山地区新生儿脐带血汞量水平较高,孕妇血汞值与脐血汞值相关,孕妇进食马鲛鱼是新生儿脐带血暴露水平的影响因素,有待进一步研究证实。     

镍对孕妇妊娠期疾病发病和妊娠结局的影响

目的分析镍对孕妇妊娠期疾病发病和妊娠结局的影响。方法选取2015年1月-2018年12月在云南省第一人民医院产科住院分娩的71例孕妇,根据孕妇健康状况分为对照组(28例)和疾病组(43例),疾病组孕妇又分为妊娠期糖尿病组(14例,妊娠期糖尿病)、妊娠期高血压疾病组(14例,妊娠期高血压疾病)及妊娠期疾病合并组(15例,妊娠期糖尿病合并妊娠期高血压疾病)。收集孕妇基本特征和新生儿出生信息,分娩后立即采集母血、胎盘及脐血样本,检测镍水平。结果对照组母血、胎盘及脐血镍水平分别为(0.08±0.13)μg/L、(0.04±0.06)μg/L及(0.05±0.07)μg/L。疾病组母血、胎盘及脐血镍水平分别为(0.05±0.07)μg/L、(0.06±0.07)μg/L及(0.11±0.20)μg/L。两组母血、胎盘及脐血镍水平比较差异均无统计学意义(t=0.889,P=0.380; t=1.334,P=0.187; t=-1.633,P=0.108)。妊娠期糖尿病组母血、胎盘及脐血镍水平分别为(0.03±0.04)μg/L、(0.04±0.07)μg/L及(0.11±0.29)μg/L。妊娠期高血压疾病组母血、胎盘及脐血镍水平分别为(0.06±0.06)μg/L、(0.06±0.05)μg/L及(0.15±0.20)μg/L。妊娠期疾病合并组母血、胎盘及脐血镍水平分别为(0.07±0.09)μg/L、(0.08±0.07)μg/L及(0.06±0.05)μg/L。妊娠期高血压疾病组和对照组脐血镍水平比较差异有统计学意义(t=-2.490,P=0.017)。对照组、疾病组母血镍水平/脐血镍水平1的比例分别为85.7%和60.5%。妊娠期糖尿病组、妊娠期高血压疾病组及妊娠期疾病合并组母血镍水平/脐血镍水平1的比例分别为71.4%、50.0%及60.0%。结论镍可通过胎盘转移至胎儿,有破坏胎盘组织的潜力。孕妇长期暴露于镍是发生妊娠期疾病和胎儿宫内生长受限的风险因素。     

上海市婴幼儿胎儿期重金属暴露水平及危险因素

目的 探讨上海市婴幼儿胎儿期重金属暴露水平及其影响因素。方法 通过分层整群抽样方法调查2008年10月至2009年10月期间在上海市10家有助产资格的医院分娩的孕产妇,共1652名。对研究对象进行问卷调查,检测脐带全血中铅、汞含量（中位数）,血清中锰、镉、砷、铊含量（中位数）,用单因素、多元线性回归方法分析其暴露危险因素。结果 脐带全血铅、汞,血清锰、镉、砷、铊含量中位数分别为41.00、1.88、4.10、0.03、0.86、0.02 μg/L。孕期每周食海鱼频率为4～7次者[9.7％( 160/1652)]血汞含量（2.76 μg/L）高于每周1～3次者[49.3％( 814/1652),2.41 μg/L]和很少食用者[40.0％ (661/1652),2.03μg/L],差异有统计学意义(x2=36.40,P＜0.001);家中用PVC管者[85.0％( 1404/1652)]脐血铅、铊含量高于用镀锌管者[15.0％(248/1652)]（铅：45.54、40.00 μg/L,Z=2.54,P＜0.05;铊：0.021、0.018 μg/L,Z=2.97,P＜0.05）,而脐血砷含量低于用镀锌管者(4.33、9.37 μg/L),差异有统计学意义(Z=3.99,P＜0.01);近3年家中有装修史者[38.0％ (628/1652)],脐血锰、镉、铊含量高于未装修者[62.0％ (1024/1652)],差异有统计学意义（锰：14.78、11.01 μg/L,Z=2.46,P＜0.05;镉：0.51、0.29 μg/L,Z=2.38,P＜0.05;铊：0.022、0.02μg/L,Z=2.81,P＜0.01）。结论 上海市婴幼儿在胎儿期存在重金属暴露.饮食及装修污染是脐血中重金属的重要来源。     

孕妇及胎儿体内铅、砷、镉、锰和锌元素水平及影响因素探讨

目的 本研究主要观察孕妇及胎儿体内铅、砷、锅、锰和锌元素的水平并对其影响因素进行探讨.方法 2006年9月至2007年4月,共采集130对母血及脐血,同时测量新生儿的生长发育指标.采用电感耦合等离子质谱法测定母血和脐血中的铅、砷、镉、锰和锌元素的含量,并对其相关关系及影响因素进行了探讨.结果 母血的铅、砷、镉、锰和锌含量中位数(μg/L)分别为64.32,3.81,0.84,54.26和6312.50.脐血的铅、砷、镉、锰和锌含量中位数(μg/L)分别为35.72,2.84,0.32,78.99和2250.镉元素(r=0.341,P=0.000)和砷元素(r=0.552,P=0.000)在母血与脐血之间呈相关性.职业有害因素及居室装修是血砷、血锌的影响因素.使用多重线性回归发现孕妇体重、职业有害因素及孕妇血压对血锰、锌、砷和镉浓度在考虑其他掺杂影响因素后有统计学意义.结论 环境因素和母体因素可能影响母血及脐血中元素含量;本研究中重金属元素含量虽低于正常参考值上限水平,但与发达国家相比,含量仍偏高,不容忽视.重金属的孕期暴露对胚胎发育的影响值得予以进一步关注.     

涪陵区中学生血中部分重金属监测结果分析

目的了解涪陵区12-14岁初中学生血中砷、铅、汞等重金属含量水平。方法在城区及农村选择初中学校各一所,分别采集城内学生血标本183人份,农村学生血样196人份,并对采集的血开展砷、铅、汞检测。结果城区学生血中砷、铅、汞含量分别为220±72μg/L、68±39μg/L、0.239±0.098μg/L;农村学生血中砷、铅、汞含量分别为132±22μg/L、41±41μg/L、0.190±0.113μg/L。结论农村学生血中砷、铅、汞含量低于城区学生,差异有统计学意义（t1=16.35,P〈0.05;t2=6.63,P〈0.05 t3=4.55,P〈0.05）。     

环境重金属内暴露与既往不良妊娠结局的相关性研究

目的探讨广西河池地区环境重金属内暴露与既往不良妊娠结局的关系。方法于2013—2014年在广西河池长老乡5个村抽取180名有妊娠史的成年女性,按照是否有既往不良妊娠结局分为不良妊娠组与对照组,以电感耦合等离子质谱法(ICP-MS)检测全血中铅、镉、砷、铬水平。以多因素logistic回归分析环境重金属内暴露与既往不良妊娠结局的关系。结果不良妊娠组血Pb几何均值(41.86μg/L)明显高于正常女性(30.48μg/L)(P0.05),两组间血镉、砷、铬的水平并没有明显差异。血铅的多重线性回归显示,血Pb与年龄及家庭年收入水平呈正相关(P0.05)。既往不良妊娠结局的多因素logistic回归分析显示,血铅每升高1μg/L,不良妊娠结局发生风险增加3.5%[OR:1.035(95%CI:1.001～1.072)];与肉类日摄入量100 g的女性相比,肉类日摄入量≥100 g的女性不良妊娠结局发生风险降低[OR:0.112(95%CI:0.011～0.568)]。结论本次调查的广西长老乡女性铅暴露可能与既往不良妊娠结局有关,建议生育期妇女应尽量避免重金属铅暴露。     

孕妇血与新生儿脐血重金属水平相关性分析

目的 检测母血及脐血中砷、铍、铬和镍浓度及相关影响因素分析.方法 随机选择125名健康住院分娩产妇作为研究对象,分别采集产前静脉血和分娩时胎儿脐血,并对产妇进行家庭社会环境和健康问卷调查.用微波消解,电感耦合等离子体-质谱仪(ICP-MS)检测全血样品砷、铍、铬和镍4种金属浓度.结果 母血中砷、铍、铬和镍浓度分别为5.27,0.01,46.98和56.07μg/L,脐血中砷、铍、铬和镍浓度分别为3.81,0.01,49.74和41.74μg/L,其中脐血中砷浓度显著低于母血(P＜0.01).母血与脐血中砷、镀、铬和镍浓度均呈现显著正相关(P＜0.01).孕妇接触职业性有害因素及近期家庭装修与母血及脐血中砷浓度有相关性.结论 孕妇和胎儿增均已暴露于砷、铍、铬和镍重金属;胎盘对铍、铬和镍缺乏有效屏障作用.     

妊娠期高血压疾病外周血胰岛素样生长因子-1和白细胞介素-1β的变化规律及意义

目的 探讨妊娠期高血压疾病外周血胰岛素样生长因子（IGF）-1和白细胞介素（IL）-1β的变化规律及意义.方法 采用酶联免疫吸附法检测115例妊娠期高血压疾病孕妇（研究组）和50例正常孕妇（对照组）外周血IGF-1、IL-1 β水平.结果 研究组分娩前空腹静脉血和分娩时新生儿脐血IGF-1水平均明显低于对照组[（212.82±21.64） μg/L比（296.69±27.18）μg/L和（52.25±7.14） μg/L比（94.89±8.07） μg/L],IL-1 β水平均明显高于对照组[（0.54±0.05）μg/L比（0.26±0.07） μg/L和（0.41±0.03） μg/L比（0.16±0.06） μg/L],差异有统计学意义（P＜0.05）.研究组内妊娠期高血压、轻度子痫前期及重度子病前期比较,随妊娠期高血压疾病的病情加重,分娩前空腹静脉血和分娩时新生儿脐血IGF-1水平亦随之降低,IL-1β水平亦随之升高,两两比较差异有统计学意义（P＜0.05）.妊娠期高血压疾病孕妇外周血IGF-1和IL-1β水平无相关性（r=0.158,P＞0.05）.结论 IGF-1和IL-1 β均可能在妊娠期高血压疾病的发病过程中发挥一定的作用,及时监测孕妇血清IGF-1和IL-1 β对于预测孕妇病情变化具有一定的临床意义.     

母婴血镉含量及其有关因素的影响

目的研究怀孕30周孕妇和其新生儿脐带血镉的含量,分析有关影响因素。方法收集66名孕妇静脉血和其新生儿脐带血各40μl,采用原子吸收光谱仪测定血镉的含量,并分析孕妇家庭和社会环境等有关因素30个项目。结果孕妇和新生儿脐血镉的平均水平分别为(2.38±0.86)μg/L和(1.66±0.62)μg/L。血镉水平≥2μg/L的人数,孕妇为42例,新生儿为17例,各占63.64%和25.76%,二者之间正相关有统计学意义(r=0.58,P<0.01)。结论孕期被动吸烟、孕期喝牛奶、孕龄、新生儿性别对脐血镉水平有显著影响。妇幼工作者应对围生期的镉损伤给予高度重视。     

吴江地区女性孕期被动吸烟与胎儿宫内汞暴露的关系调查

目的研究吴江地区女性孕期被动吸烟与胎儿宫内汞暴露的关系。方法采取整群抽样法选取孕期生活在吴江地区,并于研究期间在吴江区第一人民医院分娩的产妇和新生儿作为研究对象。调查各种汞暴露高危因素,产妇本人和丈夫吸烟史,孕期每周逗留于家庭外二手烟环境的次数。新生儿娩出后即刻取抗凝脐带血测定脐血汞水平。结果 2 496例新生儿脐血汞测定值为(2.02±1.97)μg/kg,男性新生儿与女性新生儿比较差异无统计学意义(t=0.523,P>0.05)。丈夫吸烟与丈夫不吸烟的产妇脐血汞水平及脐血汞水平>5.8μg/kg的产妇例数比较差异均有统计学意义(P<0.05)。孕期逗留于家庭外二手烟环境(每周3次或以上)与孕期未逗留于家庭外二手烟环境(每周3次或以上)的产妇脐血汞水平及脐血汞水平>5.8μg/kg的产妇例数比较差异均无统计学意义(P>0.05)。丈夫吸烟与新生儿脐带血汞水平呈明显正相关。结论孕期丈夫吸烟明显增加胎儿宫内汞暴露,应力求戒烟。家庭外二手烟环境对胎儿宫内汞暴露无影响可能与例数过少及调查中未量化接触时间有关。     

产妇和新生儿体内重金属水平及其影响因素分析

目的了解某地区产妇及新生儿血砷、汞和铅的水平,分析其相关影响因素。方法在某地区随机抽取A、B两所医院,选择2012年4—5月间住院分娩的产妇共226名,采集产妇静脉血和新生儿脐带血,采用电感耦合等离子体质谱法测定全血中砷、汞和铅的浓度,并对产妇进行问卷调查。结果 226对产妇和新生儿血铅浓度范围分别为2.65~67.00μg/L和4.05~70.89μg/L,均低于100μg/L的限值;A医院产妇和新生儿血砷平均浓度分别为1.20μg/L和1.23μg/L,均高于B医院(0.62μg/L和0.71μg/L),差异具有统计学意义(P0.05),血汞和血铅浓度差异均无统计学意义(P0.05);新生儿脐带血中砷、汞和铅浓度与产妇静脉血中同种元素浓度呈显著正相关(P0.01),相关系数分别为0.925、0.832和0.765;多重线性回归分析结果显示,家庭年收入越高,产妇及其新生儿血砷浓度越高(P0.05);产妇文化程度则对血铅水平有显著影响,文化程度越高,产妇及其新生儿血铅浓度越低(P0.05)。结论该地区产妇和新生儿体内砷、汞、铅暴露水平较低,但胎盘对重金属缺乏有效屏障作用,仍应采取有效措施减少产妇和新生儿重金属暴露。     

尿中金属元素水平与儿童急性白血病之间的关系

目的 探讨尿液中金属元素水平与儿童急性白血病发病之间的关系. 方法 选取2007年9月至2008年8月就诊于上海儿童医学中心的71例新发急性白血病患儿作为病例组,患儿均15岁以下且排除唐氏综合征及其他肿瘤性疾病.以同期就诊于该院的,年龄性别与病例组匹配,且无肿瘤和先天性疾病病史的113例患儿作为对照组.应用问卷调查研究对象一般情况,同时取其随机尿(病例组尿液取白化疗前),用电感耦合等离子体质谱仪检测尿液中金属元素含量,运用logistic模型对其进行单因素和多因素分析. 结果 问卷调查显示,母亲孕期或孕前3个月服用铁剂者,在病例组和对照组中的构成比分别为28.2%(20/71)和14.2%(16/113),差异有统计学意义(x2=5.438,P=0.02).单因素分析显示,两组尿中含量差异有统计学意义的元素分别为钒、锰、铁、钴、铜、砷、钡,且均为病例组高于对照组;病例组和对照组中钒的含量(中位数)分别为5.39、3.04 ng/mg肌酐(Wald x2=9.03,P＜0.05),锰为4.46、2.44 ng/mg肌酐(Wald x2=10.57,P＜0.05),铁为58.69、14.09 ng/mg肌酐(Wald x2=13.41,P＜0.05),钴为0.98、0.77 ng/mg肌酐(Wald x2=4.46,P＜0.05),铜为61.17、10.90 ng/mg肌酐(Wald x2=8.15,P＜0.05),砷为55.93、36.11 ng/mg肌酐(Wald x2=4.57,P＜0.05),钡为8.55、2.87 ng/mg肌酐(Wald x2=4.82,P＜0.05).多因素分析显示,尿中铁元素含量升高可增加儿童急性白血病发病风险(OR=1.009;95%CI=1.002～1.016). 结论 体内铁的水平与儿童急性白血病发病相关,其具体机制有待进一步深入研究.

Abstract：

Objective To explore the relation between the level of metallic elements in urine and childhood acute leukemia. Methods A total of 71 patients under 15 years old who were newly diagnosed with acute leukemia between September 2007 and August 2008 without Downs' syndrome or other tumors,and 113 gender-and age-matched controls without tunors or congenital diseases were enrolled for the case-control study.The general data and potential risk factors were obtained by questionnaires.Inductively coupled plasma mass spectrometry (ICP-MS) was used to determine the metal concentrations in urine,which was collected randomly before chemotherapy.Logistic regression model was performed for univariate and multivariate analysis. Results The questionnaire showed that there was significant difference in the proportion of children whose mothers had taken iron supplements during or 3 months before pregnancy between case group and control group,which was 28.2% (20/71) and 14.2% (16/113) respectively (Wald x2 = 5.438,P =0.02).Univariate logistic regression analysis showed that levels of vanadium,manganese,iron,cobalt,copper,arsenic,and barium in urine from case group were all higher than those of control group with significant difference.The median values for vanadium in urine from case and control groups were 5.39 and 3.04 ng/mg creatinine (Wald x2 = 9.03,P ＜ 0.05);the median values for manganese were respectively 4.46 and 2.44 ng/mg creatinine (Wald x2 = 10.57,P ＜0.05);the median values for iron were separately 58.69 and 14.09 ng/mg creatinine (Wald x2 = 13.41,P ＜ 0.05);the median values for cobalt were respectively 0.98 and 0.77 ng/mg creatinine (Wald x2 = 4.46,P ＜ 0.05);the median values for copper were 61.17 and 10.90 ng/mg creatinine (Wald x2 = 8.15,P ＜ 0.05);the median values for arsenic were respectively 55.93 and 36.11 ng/mg creatinine (Wald x2 = 4.57,P ＜ 0.05);and the median values for barium were 8.55 and 2.87 ng/mg creatinine (Wald x2 = 4.82,P ＜ 0.05).Multivariate logistic regression analysis showed that the level of iron in urine had a significantly positive relation with the incidence of childhood acute leukemia (OR = 1.009,95% CI = 1.002-1.016). Conclusion The level of iron in urine might be related to the occurrence of childhood acute leukemia,but its specific role needs further investigation.     

孕哺期铝暴露对仔鼠海马 N-甲基-D-天门冬氨酸受体表达的影响

目的 研究孕哺期染铝对仔鼠学习记忆和仔鼠海马组织中N-甲基-D-天门冬氨酸受体(NMDAR)表达的影响,以探讨铝对发育中的中枢神经系统的毒性作用及机制.方法 Wistar大鼠60只,雌雄各半,饲养1周后按1∶1雌雄合笼,发现阴栓即可认为雌鼠怀孕,按体重将孕鼠随机分为3组:对照组(饮用蒸馏水)、低剂量组(饮用0.2%AlCl3蒸馏水溶液)、高剂量组(饮用0.4%AlCl3蒸馏水溶液),每组10只,母鼠从怀孕开始染毒,至仔鼠哺乳期(出生后21 d)结束,共染毒6周.原子吸收石墨炉法测 定血铝和脑铝含量;跳台试验法观察大鼠学习、记忆行为学的改变;用免疫印迹(Western blot)法测定海马NMDA受体表达水平.结果 随着染铝剂量的增加,仔鼠血铝、脑铝含量明显增加,与对照组比较,差异有统计学意义(P＜0.05).低、高剂量染铝组仔鼠跳台试验的潜伏期逐渐缩短[分别为(202.71±81.99)、(19.67±8.44)s],与对照组[(300.00±0.00)s]比较,差异有统计学意义(P＜0.01),而错误次数逐渐增加(低、高剂量染铝组分别为1.43±0.85、2.47±0.99),与对照组(0.00±0.00)比较,差异有统计学意义(P＜0.01).铝暴露也可导致NMDAR各亚型的比例发生变化,低、高剂量染铝组仔鼠海马组织中NR1和NR2B含量下降(低剂量染铝组NR1和NR2B灰度值为25.22±0.68、81.23±15.37,高剂量染铝组NR1和NR2B灰度值为24.75±0.71、56.63±7.82,与对照组(NR1和NR2B灰度值分别为31.69±3.44、107.61±9.05)比较,差异均有统计学意义(P＜0.05).结论 孕哺期铝暴露可以引起发育中大鼠学习记忆能力下降,导致NMDAR各亚型的比例发生变化,NR1和NR2B含量下降可能是母体铝暴露影响子代大鼠学习记忆能力的重要分子机制之一.

Abstract：

Objective To investigate the effects of aluminum on learning and memory and the expression of N-methyl-D-aspartic acid receptor (NMDAR) of hippocampus in offspring from female rats exposed to Al in the pregnancy or lactation, and to explore the mechanism of toxic effects of Al on central nervous system (CNS) during development. Methods The pregnant Wistar rats were randomly divided into 3 groups based on their body weight, I.e. Control group was exposed to distilled water, low exposure group (0.2 %AlCl3) and high exposure group (0.4 %AlCl3) were exposed orally to AlCl3 in pregnancy and lactation for 6 weeks, 10 rats each group. Aluminum content in blood and brains was determined by atomic absorption spectrophotometry (AAS). Platform experiment was used to detect the abilities of learning and memory. The expression levels of NMDARs were detected by western blot assay. Results The Al content in blood and brains of rats in exposure groups increased significantly with Al dose, as compared with the control group ( P＜0.05 ). In platform experiment, the incubation periods of rats in low and high exposure groups were (202.71±81.99 ) and ( 19.67±8.44 )s respectively, which were significantly lower than that [( 300.00±0.00 )s] in control group (P＜0.01), but the mistake times of rats in low and high exposure groups were 1.43±0.85 and 2.47±0.99 respectively, which were significantly higher than that (0.00±0.00) in control group (P＜0.01). The Al exposure could change the proportion of NMDAR subtypes, the expression levels of NR1 and NR2B in hippocampus of newborn rats in low and high exposure groups were 25.22±0.68, 81.23±15.37 and 24.75±0.71, 56.63 ±7.82, respectively, which were significantly lower than those (31.69±3.44, 107.61±9.05 ) in control group (P＜0.05). Conclusion Aluminum exposure in pregnancy and lactation could reduce theabilities of learning and memory in newborn rats, and change the proportion of NMDAR subtypes. The reduced NR1and NR2B expression levels may be one of important mechanisms to influence the abilities of learning and memory in offspring.     

吴江地区胎儿宫内汞暴露现状及高危因素

目的:研究吴江地区胎儿宫内汞暴露的现状以及影响脐带血汞值的各种高危因素。方法:采取整群法对入院产妇进行健康因素问卷调查,所分娩的新生儿(除多胎、出生缺陷外)做脐带血汞测定。结果:2 496例新生儿脐血汞均值为(2.02±1.97)μg/kg,其中男婴(1 287例)为(2.01±1.99)μg/kg,女婴(1 209例)为(2.04±1.94)μg/kg,性别间差异无统计学意义(P>0.05)。4～6月、10～12月分娩新生儿的脐带血汞均值明显高于1～3月、7～9月(P<0.01)。经多因素回归分析,居住环境、工种、较多食用海鱼或河鱼、镶牙、生活燃煤、化妆品使用、丈夫抽烟等与脐血汞值呈显著正相关。结论:除治理工业排放污染、加强涉汞工种劳动保护外,孕期避免生活中各种汞接触高危因素同样重要。     

宫内汞暴露与新生儿体格发育指数相关性研究

【目的】 研究宫内汞暴露对新生儿体格发育指数的影响。 【方法】 研究期间对本院分娩的新生儿生后即刻取脐带血,胎发进行汞含量测定。新生儿出生后分别测定体重、身长、头围。按娩出时胎龄对照我国15城市新生儿体格发育指数测量值,求出所在百分位区间,并将脐血汞、胎发汞值进行统计学分析。 【结果】 2 316例配对测定脐血汞为(2.02±1.94)μg/kg,胎发汞为(244.06±2.24)μg/kg。 按百分位区间(10,P₁₀~P₂₅,P₂₅~P₇₅,P₇₅~P₉₀,>P₉₀)头围各组脐血汞值依次分别为2.50±1.88,2.05±1.92,1.88±1.96,1.50±1.76,1.77±1.49;胎发汞分别为360.91±2.12,262.97±2.15,201.65±2.22,205.31±2.18,208.50±1.49,差异有统计学意义(F₁=15.47,P₁=0.00;F₂=42.53,P₂=0.00)体重各组胎发汞值依次分别为195.07±2.13,227.25±2.19,247.69±2.18,252.29±2.32,246.89±2.32,各组间差异有统计学意义(F=2.57,P<0.05),但去除10组后,其余4组差异无统计学意义(F=0.91、P=0.44)。 【结论】 宫内汞暴露除影响胎儿日后智力发育外,还可能对新生儿头围产生不利影响。     

Temporal variation of blood and hair mercury levels in pregnancy in relation to fish consumption history in a population living along the St. Lawrence River

Fish consumption from the Great Lakes and the St. Lawrence River has been decreasing over the last years due to advisories and increased awareness of the presence of several contaminants. Methylmercury (MeHg), a well-established neurotoxicant even at low levels of exposure, bioaccumulates to differing degrees in various fish species and can have serious adverse effects on the development and functioning of the human central nervous system, especially during prenatal exposure. Most studies on MeHg exposure have focussed on high-level consumers from local fish sources, although mercury (Hg) is also present in fresh, frozen, and canned market fish. Moreover, little information exists on the temporal variation of blood and hair Hg in pregnant women, particularly in populations with low levels of Hg. The aim of the present study was to characterize the temporal variation of Hg during pregnancy and to investigate the relation between fish consumption from various sources prior to and during pregnancy and maternal cord blood and mother's hair Hg levels. We recruited 159 pregnant women from Southwest Quebec through two prenatal clinics of the Quebec Public Health System. All women completed two detailed questionnaires concerning their fish consumption (species and frequency) prior to and during pregnancy. The women also provided blood samples for all three trimesters of pregnancy and hair samples after delivery of up to 9 cm in length. Blood and hair Hg levels were analyzed by cold-vapor atomic-absorption and -fluorescence spectrometry methods, respectively. Results showed that maternal blood and hair Hg levels decreased significantly between the second and third trimesters of pregnancy. However, cord blood Hg was significantly higher than maternal blood at birth. Maternal hair was correlated with Hg blood concentration and was highly predictive of the organic fraction in cord blood. A strong dose relation was observed between the frequency of fish consumption before and during pregnancy and Hg exposure in mothers and newborns. Fish consumption prior to and during pregnancy explained 26% and 20% of cord blood Hg variance, respectively. For this population, detailed multivariate analyses showed that during pregnancy market fish (fresh, canned, and frozen) were more important sources of Hg exposure than were fish from the St. Lawrence River. These results should be taken into account for future advisories and intervention strategies, which should consider Hg levels in different species from all sources in order to maximize the nutritional input from fish and minimize the toxic risk.     

血清中铜、锌、镍、镉、锰等微量元素对稽留流产影响的研究

目的探讨孕早期血清中汞、锰、镍、铜、锌、砷、镉、铅水平对稽留流产的影响,为稽留流产病因研究提供线索。方法选取同年龄段、同孕周的稽留流产患者及正常早孕者21对,检测两组孕妇血清汞、锰、镍、铜、锌、砷、镉、铅水平。采用1∶1配比Logistic回归分析模型分析稽留流产可能的影响因素。结果与正常早孕组相比,稽留流产组血清镍(t=3.57,P=0.002)、铜(t=7.94,P<0.001)、锌(t=3.60,P=0.002)、镉(t=4.74,P<0.001)、砷(t=2.82,P=0.011)、铅(t=3.46,P=0.002)水平较高,血清锰水平较低(t=-8.24,P<0.001);二元多因素Logistic回归分析模型分析结果显示,高血镍(OR=7.83,95%CI:1.03~59.68,P=0.037)、高血镉(OR=3.51,95%CI:2.53~4.87,P=0.004)为稽留流产的危险因素,高血锰(OR=0.68,95%CI:0.41~0.97,P=0.030)为保护性因素。结论孕妇血清中镍、镉、锰水平对稽留流产的发生有一定的影响,其机理有待于进一步研究。     

竹荪多糖早期和晚期干预对砷中毒大鼠肝功能的影响

目的探讨砷致肝损伤大鼠体内砷含量和肝功能受竹荪多糖干预的影响。方法 108只成年清洁级SD大鼠随机分为正常对照组(24只,以普通饲料喂饲)、砷+竹荪同时干预组[(简称同时干预组),24只,10 mg/ml的竹荪多糖每日20ml/kg灌胃,且饲料中砷含量为50 mg/kg]、砷染毒组(60只,喂饲砷含量50 mg/kg的饲料),均雌雄各半。采用喂饲法进行染毒3个月后,以HE、Masson染色观察肝损伤情况。继续将砷染毒组随机均分为砷染毒组、砷+二巯基丙磺酸钠(DMPS)组[(简称DMPS组),每天以5 mg/kg二巯基丙磺酸钠腹腔注射,连续3 d,间隔4 d为一个周期]、砷+竹荪后干预组[(简称竹荪后干预组),10 mg/ml竹荪多糖每日20 ml/kg灌胃],每组18只,雌雄各半,三组均以砷含量为50 mg/kg的饲料喂饲,各组再处理3个月,观察大鼠体内砷含量和肝功能的变化情况。结果肝脏HE、Masson染色显示,与正常对照组比较,同时干预组、砷染毒组光镜下肝组织均有不同程度肝损伤出现。与正常对照组相比,各处理组大鼠血清ALT和AST的活力升高,且随着染毒时间的增加,各组大鼠血清ALT和AST的活力呈上升趋势。与正常对照组相比,各处理组大鼠血、尿、肝脏砷含量均增高(P0.05)。与砷染毒组相比,同时干预组、DMPS组、竹荪后干预组肝砷降低,血砷和尿砷升高(P0.05)。与DMPS组相比,同时干预组肝砷先降低后升高,尿砷先升高后减低,血砷先升高后减低再升高(P0.05)。与同时干预组相比,竹荪后干预组肝砷升高,血砷、尿砷降低(P0.05)。与竹荪后干预组相比,DMPS组肝砷降低,尿砷升高,血砷先升高后降低(P0.05)。结论竹荪多糖早期干预能减轻砷中毒大鼠肝损伤程度,且竹荪在砷中毒早期干预对肝损伤的减轻效果优于砷中毒后再干预,但竹荪多糖对砷中毒大鼠体内驱砷效果仍不及二巯基丙磺酸钠。     

妊娠各期孕妇甲状腺激素变化的探讨

目的 探讨妊娠各期孕妇的甲状腺激素变化及其甲状腺功能状态.方法 采用ACS-180化学发光分析仪检测623例孕妇的血清游离三碘甲状腺原氨酸（FT3）、游离甲状腺激素（FT4）、促甲状腺激素（TSH）和人绒毛膜促性腺激素（hCG）;利用碘催化砷铈反应原理,采用冷消解快速尿碘定量检测方法 测定孕妇一次随意尿的尿碘含量.结果 妊娠早、中期的FT3、FT4和hCG高于妊娠晚期（F=53.19,78.00,58.77,P＜0.05）,而TSH低于妊娠晚期（F=5.68,P＜0.05）.孕妇甲状腺功能紊乱发生率为7.54%,妊娠各期孕妇的甲状腺功能紊乱发生率的差异无统计学意义（χ2=3.92,P＞0.05）.亚临床甲减、亚临床甲亢、甲减和甲亢的发生率分别是3.53%、2.57%、1.12%和0.32%.妊娠早期和妊娠晚期均以亚临床甲减居多,妊娠中期以亚临床甲亢居多.结论 孕妇妊娠晚期的甲状腺功能相对孕早、中期而言处于一种轻微甲状腺功能减低的代偿状态,孕期激素变化不是引起孕妇甲状腺功能紊乱的主要因素.     

乌市水区新生儿脐血与孕母血维生素D水平的相关性及其影响因素

目的了解新生儿脐带血与孕母妊娠末期血维生素D水平的相关性,探讨影响新生儿脐血维生素D水平的相关因素。方法对自2015年11月-2016年3月冬季收住的112例新生儿脐血及其中40例的孕母产前静脉血采用化学发光法测定维生素D值,进行相关性分析。结果 112例新生儿脐血25(OH)D平均水平为(6.75±3.59)ng/ml,新生儿维生素D均处于缺乏状态,中、重度维生素D缺乏新生儿占85.7%。40例孕母血25(OH)D平均水平与新生儿血25(OH)D水平呈显著正相关(r=0.86,P0.001);孕妇的民族、孕期补钙时间、海产品摄入次数与孕妇文化程度等对新生儿维生素D水平的影响有统计学意义;孕妇不同孕周、工作类型、户外活动时间、孕期是否抽筋及新生儿胎产次、胎儿性别、出生方式等对新生儿维生素D水平的影响无统计学意义(P0.05)。结论冬季出生的新生儿维生素D缺乏严重,与孕妇妊娠末期静脉血维生素D水平显著相关。冬季应给予孕晚期孕妇补充足量维生素D,以提高新生儿维生素D水平。