矿区学龄前儿童的血铅水平及其对发育与甲状腺功能的影响
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摘要
目的分析血铅水平对矿区学龄前儿童体格和智能发育及甲状腺功能的影响。方法采用随机整群抽样法,在广西某矿区抽取180名学龄前儿童,根据血铅水平将其分为正常组112例和异常组68例。测量纳入儿童的身高、体重、头围,采用Gesell发育量表评估其智能发育水平,并检测甲状腺激素水平。结果异常组血铅水平高于正常组(P <0. 05),血铅异常者中,高铅血症45例,轻度铅中毒11例,中度铅中毒12例。异常组男童和女童的身高、体重均小于正常组,各项发育商及促甲状腺激素(TSH)水平均低于正常组(均P <0. 05)。异常组血铅水平与身高、体重、各项发育商及血清TSH水平均呈负相关(均P <0. 05),但正常组血铅水平与各指标均无相关性(P>0. 05)。结论矿区学龄前儿童可出现血铅水平异常甚至铅中毒,这可对其体格和智能发育,以及甲状腺功能造成不良影响。
Objective To analyze the impact of serum lead level on physical and intellectual development and thyroid function among preschool children from mining area. Methods A total of 180 preschool children were enrolled from a mining area in Guangxi using random cluster sampling method,and the children were divided into normality group( n = 112) and abnormality group( n = 68) according to their serum lead levels. Body height,body weight,and head circumference were measured in the children recruited,their physical and intellectual development levels were evaluated by Gesell Development Schedules,and their thyroid hormone levels were detected as well.Results The serum lead level in the abnormality group was higher than that in the normality group( P < 0. 05),children with serum lead abnormality included 45 cases exhibiting a high lead level,11 of mild lead poisoning,and 12 of moderate lead poisoning. Boys and girls in the abnormality group had lower body height and less body weight than the normality group,the abnormality group had lower levels of all development quotients and lower thyroid-stimulating hormone( TSH)level than the normality group( all P < 0. 05). Serum lead level negatively correlated with body height,body weight,each development quotient,or serum TSH level in the abnormality group( all P < 0. 05),however,no correlation was found between serum lead level and each index mentioned above in the normality group( P > 0. 05). Conclusion Preschool children in the mining area may experience serum lead abnormality even saturnism,which may have adverse effects on their physical and intellectual development and thyroid function.
Objective To analyze the impact of serum lead level on physical and intellectual development and thyroid function among preschool children from mining area. Methods A total of 180 preschool children were enrolled from a mining area in Guangxi using random cluster sampling method,and the children were divided into normality group( n = 112) and abnormality group( n = 68) according to their serum lead levels. Body height,body weight,and head circumference were measured in the children recruited,their physical and intellectual development levels were evaluated by Gesell Development Schedules,and their thyroid hormone levels were detected as well.Results The serum lead level in the abnormality group was higher than that in the normality group( P < 0. 05),children with serum lead abnormality included 45 cases exhibiting a high lead level,11 of mild lead poisoning,and 12 of moderate lead poisoning. Boys and girls in the abnormality group had lower body height and less body weight than the normality group,the abnormality group had lower levels of all development quotients and lower thyroid-stimulating hormone( TSH)level than the normality group( all P < 0. 05). Serum lead level negatively correlated with body height,body weight,each development quotient,or serum TSH level in the abnormality group( all P < 0. 05),however,no correlation was found between serum lead level and each index mentioned above in the normality group( P > 0. 05). Conclusion Preschool children in the mining area may experience serum lead abnormality even saturnism,which may have adverse effects on their physical and intellectual development and thyroid function.
引文
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[11]邱炜,陈莹,胡秀,等.云南某地区儿童及青少年铅中毒现状及影响因素分析[J].昆明医科大学学报,2016,37(11):18-22.
[12]刘俊晓,王孟丽,王战会.铅污染区学龄前儿童血铅暴露水平及其对儿童体格发育的影响[J].河南科技大学学报(医学版),2016,34(1):60-62.
[13] O'Shaughnessy KL,Wood CR,Ford RL,et al. Thyroid hormone disruption in the fetal and neonatal rat:predictive hormone measures and bioindicators of hormone action in the developing cortex[J]. Toxicol Sci,2018,166(1):163-179.
[14]吴传云.左旋甲状腺素对发育期铅暴露引起的大鼠甲状腺功能减退和海马突触性损伤的修复作用[D].合肥:中国科学技术大学,2011.
[2]蔡德雷,孟真,汤鋆,等.不同地区10~11岁儿童血铅水平和相关血清学指标研究[J].预防医学,2017,29(5):449-451.
[3]杨玉凤.儿童常用的发育评估方法[J].中国实用儿科杂志,2016,31(10):739-743.
[4]中华人民共和国卫生部.儿童高铅血症和铅中毒预防指南[J].中国生育健康杂志,2006,17(4):196.
[5]中华人民共和国卫生部.儿童高铅血症和铅中毒分级和处理原则[J].中国生育健康杂志,2006,17(4):197-198.
[6] Markowitz G. The childhood lead poisoning epidemic in historical perspective[J]. Endeavour,2016,40(2):93-101.
[7] Hon KL,Fung CK,Leung AK. Childhood lead poisoning:an overview[J]. Hong Kong Med J,2017,23(6):616-621.
[8] Zhang XY,Carpenter DO,Song YJ,et al. Application of the IEUBK model for linking children's blood lead with environmental exposure in a mining site,south China[J]. Environ Pollut,2017,231(Pt 1):971-978.
[9]罗宇超,赵红宇,朱为梅,等.某铅锌矿区周边1379名儿童血铅水平分析[J].中华劳动卫生职业病杂志,2017,35(8):571-574.
[10]曹朝晖,龙石银,周艺,等.衡阳市某矿区儿童铅中毒现状的调查[J].微量元素与健康研究,2015,32(2):28-29.
[11]邱炜,陈莹,胡秀,等.云南某地区儿童及青少年铅中毒现状及影响因素分析[J].昆明医科大学学报,2016,37(11):18-22.
[12]刘俊晓,王孟丽,王战会.铅污染区学龄前儿童血铅暴露水平及其对儿童体格发育的影响[J].河南科技大学学报(医学版),2016,34(1):60-62.
[13] O'Shaughnessy KL,Wood CR,Ford RL,et al. Thyroid hormone disruption in the fetal and neonatal rat:predictive hormone measures and bioindicators of hormone action in the developing cortex[J]. Toxicol Sci,2018,166(1):163-179.
[14]吴传云.左旋甲状腺素对发育期铅暴露引起的大鼠甲状腺功能减退和海马突触性损伤的修复作用[D].合肥:中国科学技术大学,2011.