国内儿童注意缺陷多动障碍与血铅水平关系的Meta分析  

The blood lead level in children with ADHD: a meta-analysis

作　　者：刘佩意[1] 让蔚清[1] 明心海 孔婷[1] 熊文婧[2] 王穆[1] 杨慧仙[3] 

机构地区：[1]南华大学公共卫生学院预防医学系,湖南衡阳421001 [2]北京中医药大学基础医学院询证医学中心,北京100029 [3]南华大学公共卫生学院卫生检验与检疫系,湖南衡阳421001

出　　处：《中华疾病控制杂志》2014年第11期1073-1078,共6页Chinese Journal of Disease Control & Prevention

基　　金：全国教育科学规划课题重点项目(GLA102077);湖南省卫生厅科研项目(B2010-043);湖南省大学生研究性学习和创新性实验计划(湘教通(2011)272号);衡阳市科技发展计划(2013KS26);南华大学哲学社会科学基金(2011XWT05;2011XWT06)

摘　　要：目的应用Meta分析评价我国儿童血铅水平与儿童注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)的关系。方法检索和收集1979-2012年国内发表的关于ADHD与血铅水平关系的文献,对纳入的26篇文献进行Meta分析。结果经Meta分析异质性检验,显示各研究结果不同质(x2=1 896.09,P<0.001,I2=98.7%),采用随机效应模型分析。结果显示,ADHD儿童的血铅水平明显高于正常对照组儿童的血铅水平,其合并标准化均数差和95%可信区间分别为35.63(30.78,40.48),合并效应量检验Z=14.41,P<0.001。敏感性分析,在剔除质量较差的研究后得到的合并标准化均数差和95%置信区间分别为28.67(27.91,36.82),显示结果稳定。漏斗图显示资料分布不是很对称,图形底部有缺角,计算失安全数得Nfs,0.05=65.42,Nfs,0.01=37.55。结论现有文献的分析结果显示,血铅水平与儿童ADHD有关,ADHD组儿童的血铅平均水平高于对照组。Objective To analyze and evaluate the relationship between blood lead level and the children with attention deficit hyperactivity disorder（ ADHD） by meta-analysis. Methods All literatures of the relationship between blood lead level and ADHD published from 1979 to 2012 in China were searched and collected. There were 26 articles included for Meta analysis. Results Heterogeneity test of meta analysis results showed that these papers were inhomogeneous（χ^2=1 896. 09,P〈0. 001,I^2= 98. 7%）. Therefore,a random effect model was used. The results showed that ADHD children＇s blood lead levels were significantly higher than the normal control group the blood lead level of children. The average standard mean difference（ SMD） and 95% confidence interval of blood lead were 35. 63（ 30. 78,40. 48）. Test for overall effect was Z = 14. 41,P〈0. 001. Because after weeding out poor quality studies,the merger of the standardized mean difference and 95% confidence interval were 28. 67（ 27. 91,36. 82） respectively,the result of sensitivity analysis was stable. Funnel chart showed that data distribution was not very symmetric,and there was lack of angle at the bottom of the graphics with computing security in number of Nfs,0. 05= 65. 42,Nfs,0. 01= 37. 55. Conclusions According to the literatures now available,the result of analysis shows that blood lead level is correlated with the occurrence of ADHD,and the blood lead level of children with ADHD is higher than that of the control group on average.

关 键 词：铅 注意力缺陷障碍伴多动 儿童 META分析 

分 类 号：R742.89[医药卫生—神经病学与精神病学]