低水平铅暴露对婴幼儿神经行为发育的影响及早期干预研究

目的 探讨低水平铅暴露对婴幼儿神经行为发育的影响及早期干预效果.方法 采用原子吸收光谱法对系统管理中生后6个月的足月正常婴儿进行血铅、镉、铁、锌、铜、镁和钙水平检测,根据血铅水平将入选的276例婴儿分为对照组、低铅组和高铅组.同时,运用Gesell发育诊断量表对入选对象进行神经行为发育商数评估.在此基础上,给予低铅组和高铅组婴儿干预性治疗3个月,并分别于婴儿生后12和18个月时进行神经行为发育商数及血铅、镉、铁、锌、铜、镁和钙水平复测.结果 高铅组婴儿神经行为发育商数最低(86.74±9.35)分,低铅组次之(91.52±9.07)分,对照组最高(100.71±6.92)分.干预后,低铅组和高铅组婴儿神经行为发育商数均提高,但以前者为著.到婴儿生后18个月时,低铅组婴儿神经行为发育商数与对照组相近(t=1.721,P＞0.05);高铅组与对照组比较差异仍存在统计学意义(t=23.495,P＜0.01).结论 低水平铅暴露可阻碍婴幼儿神经行为发育,早期干预能改善其影响.

Effects of low-level lead exposure on the neurobehavioral development of infants and early intervention

OBJECTIVE: To explore the effects of low-level lead exposure on infant's neurobehavioral development and evaluate the effects of early intervention. METHODS: The study population consisted of 276 infants whose blood lead, cadmium, iron, zinc, copper, magnesium and calcium concentrations were measured by atomic absorption spectroscopy and developmental status were assessed using the Gesell developmental Diagnosis scales (GDDS) at 6 months of age. All study subjects was divided into three groups: 58 infants in control group, 162 infants in low lead group and 56 infants in high lead group. On the basis infants of both the low and high lead groups were provided with interventional measures for 3 months, and tests for the blood lead, cadmium, iron, zinc, copper, magnesium, calcium and GDDS were repeated for all infants both 12 and 18 months of ages. RESULTS: Infant' s developmental outcome revealed the developmental quotient was the lowest in the high lead group (86.74 +/- 9. 35), the lesser low in the low lead group (91.52 +/- 10.12) and the highest in control group (100.71 +/- 6.92). Changes in developmental quotient were detected in both the low and high lead groups with statistical significance (P < 0.05) after intervention measures adopted. However, the changes of developmental quotient were more remarkable in the low lead group and after the 18th month there was no statistical significance than control group (t = 1.721, P > 0.05) while the significant difference was found in between the high lead group and the control group (t = 23.495, P < 0.05). CONCLUSION: Low-level lead exposure interfered infant's neurobehavioral development and early intervention might improve infant's developmental quotient.