铅中毒对学龄儿童听性脑干反应的影响

目的 观察铅中毒对学龄儿童听觉神经系统的损害。方法 对100例无神经系统阳性体征的铅中毒儿童进行听性脑干反应、纯音测听及畸变产物耳声发射检测，并将其分为补钙组和未补钙组，观察治疗前后的听性脑干反应、纯音测听及畸变产物耳声发射的变化，同时与50例年龄性别相匹配的血铅正常儿童进行对比分析。结果 治疗前铅中毒组和正常组听性脑干反应比较：铅中毒组Ⅴ波潜伏期较正常组延长，差异有统计学意义（t=3．21，P〈0．01），Ⅰ、Ⅲ波潜伏期较正常组延长，但差异无统计学意义（前者t=2．06，P〉0．05，后者t=1．64，P〉0．05）。铅中毒组Ⅲ～Ⅴ、Ⅰ～Ⅴ波间期较对照组延长，差异有统计学意义（前者t=7．30，P〈0．01，后者t=3．14，P〈0．01），Ⅰ～Ⅲ波间期较对照组延长，但差异无统计学意义（t=0．91，P〉0．05）。铅中毒组Ⅰ、Ⅲ、Ⅴ波波幅均低于正常组，差异有统计学意义（Ⅰ波-t=3．20，P〈0．01，Ⅲ波：t=3．31，P〈0．01，Ⅴ波：t=3．41，P〈0．01）。补钙组、未补钙组及血铅正常组治疗半年前后比较：3组听性脑干反应各指标在治疗前后均无统计学意义（P〉0．05）。纯音测听及畸变产物耳声发射检测前后差异均无统计学意义（P值均〉0．05）。结论 铅中毒可以引起神经系统的亚临床损害，补钙对治疗后ABR无显著改变，ABR对于早期发现铅中毒对神经系统损害有一定的价值。

Effect of plumbism on auditory brainstem response of children

OBJECTIVE: To observe the injury of plumbism to the nerve system in children. METHODS: One hundred children with plumbism which had no masculine body sign of nerve system were divided into two groups. Fifty of them were as controls, while others were treated by calcium. Fifty age and gender matched healthy children were selected as the normal group in order to compare with plumbism group. All of their auditory brainstem response (ABR), pure tone and distortion product otoacoustc emission (DPOAE) were examined. RESULTS: Latency period of wave V of the plumbism groups was longer than that of normal group. The difference between them was significant statistically (t =3.21, P <0.01). The interval between wave I and wave III of plumbism group was longer than that of normal group, but there was no difference between them (former: t = 2.06, P > 0.05; later: t = 1.64, P > 0.05). The interval between wave III and wave V and the interval between wave I and wave V of plumbism group was longer than that of normal group, and their difference was significant statistically (former: t = 7.30, P <0.01; later: t = 3.14, P < 0.01). The interval between wave I and wave III of plumbism group was longer than that of normal group, but there was no difference between them (t = 0.91, P > 0.05). The amplitude of wave I, wave III and wave V of plumbism group was lower than that of normal group, and their difference was significant statistically (I: t =3.20, P < 0.01; III: t=3.31, P < 0.01; V: t=3.41, P < 0.01). The auditory brainstem response, pure tone and DPOAE in all three groups had no obvious change after six months treatment (P >0.05). CONCLUSIONS: Plumbism may have potential clinical injury to nerve system. There has no obvious change of ABR after treatment by calcium. ABR may be a forepart examination to find the injury of plumbism to the nerve system.