运用事件相关电位探讨铅暴露对儿童认知功能的影响  

Using ERP to explore the effects of lead exposure on cognitive function in children

作　　者：杨颖 郜振彦[2] 颜崇淮[2] YANG Ying;GAO Zhenyan;YAN Chonghuai(School of Public Health,Shanghai Jiao Tong University,Shanghai 200025,China;MOE-Shanghai Key Laboratory of Children's Environmental Health,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200092,China)

机构地区：[1]上海交通大学公共卫生学院,上海200025 [2]上海交通大学医学院附属新华医院/教育部和上海市环境与儿童健康重点实验室,上海200092

出　　处：《中国妇幼健康研究》2021年第2期182-187,共6页Chinese Journal of Woman and Child Health Research

基　　金：国家重点基础研究发展计划(2012CB525001)。

摘　　要：目的运用事件相关电位(ERP)探讨铅暴露对儿童认知功能的影响。方法选取2017年3月至2019年11月就诊于上海交通大学医学院附属新华医院儿童重金属门诊的66例儿童为研究对象,检测受试儿童血铅水平,进行智力测试、心理行为评估,收集ERP的失匹配负波(MMN)和P3a,采用多元线性回归分析铅暴露与儿童认知功能的关系。结果66例儿童的平均年龄为(62.73±8.65)月龄,血铅水平为42.50(12.00~120.75)μg/L;儿童语言分、操作分和智商总分均值分别为(111.12±14.71)分、(111.56±14.62)分和(112.53±13.64)分,其中儿童血铅与语言分为负相关关系(r=-0.257,P<0.05);儿童血铅水平与父亲的受教育程度、母亲的受教育程度和家庭收入均呈负相关关系(r值分别为-0.498、-0.431、-0.349,均P<0.05),尚未发现血铅水平与心理行为量表评估之间的相关关系(均P>0.05);血铅水平、年龄与大脑Cz区的MMN波幅存在负相关关系(r值分别为-0.293、-0.307,均P<0.05),尚未发现儿童血铅与MMN潜伏期以及P3a的波幅和潜伏期之间存在相关关系(均P>0.05);多元线性回归分析结果显示,控制混杂因素后,儿童血铅水平与MMN波幅之间的回归系数β值及95%CI为-0.01(-0.02~0.00),标准回归系数为-0.34,P<0.05。结论血铅水平与MMN波幅为负相关关系,提示铅暴露影响了儿童大脑对信息的自动加工处理,可以将ERP作为一种客观灵敏的手段评估铅暴露对儿童认知功能的影响。Objective Event related potentials(ERP)is used to investigate the effects of lead exposure on children’s cognitive function.Methods From March 2017 to November 2019,66 eligible children were collected from the Pediatric Heavy Metal Clinic of Xinhua Hospital.We tested their blood lead level,conducted intelligence tests,psychological behavior assessment,and collected ERP Mismatch negative wave(MMN)and P3 a,and we used multiple linear regression to analyze the relationship between lead exposure and children’s cognitive function.Results A total of 66 children were included in the study,with an average age of(62.73±8.65)months and blood lead median value of 42.50(12.00~120.75)μg/L.The mean scores of language,operation and IQ were(111.12±14.71),(111.56±14.62)and(112.53±13.64),respectively,among which the blood lead of children was negatively correlated with language(r=-0.257,P<0.05).Children’s blood lead level was negatively correlated with their father’s education level,their mother’s education level and their family income(r=-0.498,-0.431 and-0.349,respectively,all P<0.05).There was no correlation between blood lead level and the assessment of psychological behavior scale(all P>0.05).There was a negative correlation between blood lead level and age and the amplitude of MMN in the Cz region of the brain(r=-0.293 and-0.307,respectively,both P<0.05).There was no correlation between blood lead and the latency of MMN and P3 a(all P>0.05).The results of multiple linear regression analysis showed that after controlling for confounding factors,the regression coefficientβvalue and 95%CI between blood lead level and MMN amplitude were-0.01(-0.02~0.00),and the standard regression coefficient was-0.34,P<0.05.Conclusion Blood lead levels are negatively correlated with MMN amplitude,suggesting that lead exposure affects the automatic processing of information in children’s brains.ERP can be used as an objective and sensitive method to assess the effects of lead exposure on the cognitive function of children.

关 键 词：儿童 铅 事件相关电位 失匹配负波 

分 类 号：R179[医药卫生—妇幼卫生保健]