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儿童铅暴露:血液中的铅水平、中毒患病率及相关因素。

Lead exposure in children: levels in blood, prevalence of intoxication and related factors.

作者信息

Solé E, Ballabriga A, Domínguez C

机构信息

Hospital Vall d'Hebron, Pediatrics Department, School of Medicine, Universitat Autònoma de Barcelona, Spain.

出版信息

Biometals. 1998 Sep;11(3):189-97. doi: 10.1023/a:1009253611000.

Abstract

Lead is a highly toxic metal, the main source of which is contamination from combustion of unleaded petrol. The aims of this work were to detect the degree of lead exposure in a large sample of children; determine the relationship between blood lead levels (BPb) and age, sex, habitat and season of the year; and correlate BPb with zinc protoporphyrin (ZPP) values. A cross-sectional study was carried out. Blood from routine extractions drawn at our centre was used. BPb and ZPP were measured by atomic absorption spectrophotometry and haematofluorimetry, respectively. We analysed 1158 blood samples from children. BPb (mean +/- SEM): 0.22 +/- 0.04 mumol l-1. Correlation BPb-age: BPb = 0.19 + 0.086 x age (months), r = 0.129, P < 0.0001. BPb was greater in boys (0.23 +/- 0.007 versus 0.20 +/- 0.006 mumol l-1, P < 0.0002). No differences were observed between habitats (urban versus rural). BPb were higher in the warm months (0.24 +/- 0.013 versus 0.21 +/- 0.007 mumol l-1, P < 0.0001). Prevalence of lead intoxication (BPb > 0.48 mumol l-1) was 4.2%. No differences in prevalence were found among the different groups. The correlation between BPb and ZPP showed r = 0.0969, P = 0.0024. Utility for screening: sensitivity of 53.7% and specificity of 59.3% (cut-off point of 60 mumol ZPP mol-1 haem). We can conclude that lead exposure in children in our sample was in the range reported in similar studies in other areas and countries, and below the toxic limit. None of the factors analysed significantly influenced lead intoxication prevalence. There was no good correlation between ZPP and BPb in our samples and the ZPP cut-off point used did not present good specificity and sensitivity values.

摘要

铅是一种剧毒金属,其主要来源是无铅汽油燃烧造成的污染。这项工作的目的是检测一大群儿童的铅暴露程度;确定血铅水平(BPb)与年龄、性别、居住环境和季节之间的关系;并将BPb与锌原卟啉(ZPP)值进行关联。开展了一项横断面研究。使用了在我们中心常规采血所获得的血液。BPb和ZPP分别通过原子吸收分光光度法和血液荧光测定法进行测量。我们分析了1158份儿童血样。BPb(均值±标准误):0.22±0.04μmol l⁻¹。BPb与年龄的相关性:BPb = 0.19 + 0.086×年龄(月),r = 0.129,P < 0.0001。男孩的BPb水平更高(0.23±0.007对比0.20±0.006μmol l⁻¹,P < 0.0002)。不同居住环境(城市与农村)之间未观察到差异。温暖月份的BPb水平更高(0.24±0.013对比0.21±0.007μmol l⁻¹,P < 0.0001)。铅中毒(BPb > 0.48μmol l⁻¹)的患病率为4.2%。不同组之间的患病率未发现差异。BPb与ZPP之间的相关性显示r = 0.0969,P = 0.0024。筛查效用:敏感度为53.7%,特异度为59.3%(ZPP截断点为60μmol ZPP mol⁻¹血红蛋白)。我们可以得出结论,我们样本中儿童的铅暴露处于其他地区和国家类似研究报告的范围内,且低于毒性限值。所分析的因素均未对铅中毒患病率产生显著影响。我们样本中ZPP与BPb之间没有良好的相关性,所使用的ZPP截断点未呈现出良好的特异度和敏感度值。

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