环境铅污染对2～3岁幼儿行为问题影响的队列分析  

A Cohort Analysis of the Effects of Environmental Lead Pollution on Behavior Problems Among Children Aged 2-3

作　　者：朱中平[1] 沈彤[1] 俞翠莲[2] 邹武庆[2] 刘俊玲 姜玉屏 朱启星[1] 

机构地区：[1]安徽医科大学公共卫生学院,合肥230032 [2]池州市疾病预防控制中心 [3]池州市贵池区妇幼保健所

出　　处：《中国学校卫生》2005年第10期830-832,共3页Chinese Journal of School Health

基　　金：安徽省教育厅科研基金资助(2003KJ179);安徽省高校省学术带头人科研基金资助(2002HBL10);安徽省计划生育科研项目;安徽省卫生厅科研项目(2002B090)

摘　　要：目的研究出生前后不同时期婴幼儿暴露水平及其父母基线血铅水平、母亲孕中血铅水平等对幼儿行为问题的影响及其关联程度.方法采用前瞻性队列研究的方法,从1996年开始在环境铅污染较严重的安徽省池州市某区进行了为期6 a的流行病学调查.对新婚夫妇进行追踪观察至分娩,并定期观察随访其子女发育情况.共采集到210对夫妇基线血样,93份孕中血,98份脐带血样.采用PE-AA800原子吸收光谱仪进行血铅水平检测.2001年11月,研究组再次系统地对队列内夫妇的165名子女进行体格检查和问卷调查,采用2～3岁Achenbach幼儿行为量表(CBCL)对幼儿进行行为问题测试,并在婴幼儿体检时采集指血165份进行了血铅检测.结果(1)母亲基线血铅、父亲基线血铅、婴幼儿血铅、脐带血铅和孕中血铅几何均值依次为(62.71±2.18)μg/L,(72.93±2.06)μg/L,(130.39±1.88)μg/L,(54.32±2.11)μg/L和(50.93±1.95)μg/L;血铅超过100 μg/L样本所占比例分别为32.38%,38.09%,43.03%,10.20%和9.68%.(2)幼儿行为问题发生率为12.12%.高血铅组与正常血铅组幼儿在攻击、破坏行为、外向性等6个方面差异有统计学意义(P＜0.05).(3)单因素相关分析和多因素逐步回归分析显示幼儿血铅水平与外向性行为得分间存在正相关(β=0.01 243,P＜0.05).结论出生前后铅暴露水平对婴幼儿行为问题有一定的不良影响,尤以幼儿当前血铅水平影响更为显著.Objective To study the effects of lead pollutiou of infant＇s blood lead level before and after birth, parents＇ baseline blood lead level （BBLL） and mid-pregnancy blood lead level （MPBLL） on infants＇ behavior problems. Methods From 1996, a six-year epidemiologic cohort study was cartied out in a place of severe environmental lead pollution, Guichi District of Chizhou City in Anhui Province, China. Prospective cohort study was followedup among newlyweds with the intention to pregnancy and their children＇ s development. A total of 210 couples, BBLL, 93 cases of MPBLL and 98 cases of umbilical cord blood （UCBLL） were assayed. The blood lead level was determined with the instrument of PE- AA800 Atomic Absorption Spectrophotometer. In November in 2001, a physical examination was conducted anlong 165 infants aged 2-3 years, their behavior problems were tested with Achenbach Child Behavior Checklist （CBCL） and their blood lead level was also measured. Results 1 ） Geonretric mean of mother BBLL and father BBLL , infants BLL, UCBLL and MPBLL were 162.71 ± 2.18）μg/L, （72.93 ±2.06）μg/L, （130.39± 1.88） μg/L, （54.32±2.11）μg/L and （50.93±1.95）μ/L, and the propoaiou that BLL were over 100μg/L were 32.38 %, 38.09 %, 43.03 %, 10.20 % and 9.68 % respectively. 2 ） In 165 infants, the incidence of abnormal behavior problems was 12.12%. The scores of 6 factors （attack, destructivityt, extraversion, etc） in high blood lead level group were much higher than those in normal blood lead level. 3 ） The single correlative and the multiple stepwise regression analysis showed that the score of extraversion was positively correlated signidficantly with infant BLL（β = 0.0124 3, P 〈 0.05）. Conclusion There are adverse effects of different periods lead exposre（especially of the infant BLL） on infant behavior probleras.

关 键 词：铅 血液化学分析 危险行为 队列研究 儿童 

分 类 号：R179[医药卫生—妇幼卫生保健] R395.6[医药卫生—公共卫生与预防医学]