经颅磁刺激治疗儿童铅中毒的临床效果及其对神经功能的影响  

Clinical effect of transcranial magnetic stimulation on lead poisoning in children and its effect on neurological function

作　　者：柏璐 王霞[1] 崔海静[1] 张静[1] 张明静 张远达[2] 郭爱民 BAI Lu;WANG Xia;CUI Hai-jing;ZHANG Jing;ZHANG Ming-jing;ZHANG Yuan-da;GUO Ai-min(Psychological Behavior,Department of Child Health Care Department of,Hebei Children's Hospital,Shijiazhuang 050031;Department of Pediatrics,Baoding Children's Hospital,Baoding 071000;Department of Pediatrics,Cixian People's Hospital,Handan 056500,Hebei,China)

机构地区：[1]河北省儿童医院儿童保健科·心理行为科,河北石家庄050031 [2]保定市儿童医院儿科,河北保定071000 [3]磁县人民医院儿科,河北邯郸056500

出　　处：《川北医学院学报》2022年第7期856-860,共5页Journal of North Sichuan Medical College

基　　金：河北省医学科学研究课题计划(20211385)。

摘　　要：目的:探讨经颅磁刺激治疗儿童铅中毒的临床效果及其对神经功能的影响。方法:根据治疗方式不同将100例铅中毒患儿分为观察组和对照组,每组各50例。观察组采用经颅磁刺激联合金属硫蛋白治疗,对照组仅采用金属硫蛋白治疗;检测两组治疗前后血铅、锌、铁、镁、钙、铜水平、肝肾功能指标及血常规;评价两组治疗前后的认知功能,日常生活能力和站立与步行能力;采用酶联免疫吸附法测定两组治疗前后脑源性神经营养因子(BDNF)、神经元特异性烯醇化酶(NSE)和白细胞介素-6(IL-6)的水平。结果:治疗前,两组血铅、锌、铁、镁、钙、铜水平比较,差异均无统计学意义(P>0.05);治疗后,两组血铅水平下降(P<0.05),锌、铁、镁水平增加(P<0.05),钙、铜水平比较差异无统计学意义(P>0.05)。治疗前,两组血红蛋白、红细胞及白细胞水平比较,差异均无统计学意义(P>0.05);治疗后,两组血红蛋白水平上升(P<0.05),红细胞和白细胞水平比较差异无统计学意义(P>0.05)。治疗前,两组Gesell评分、ADL评分及GMFM-88评分比较,差异均无统计学意义(P>0.05);治疗后,两组Gesell评分、ADL评分及GMFM-88评分增加(P<0.05),且观察组改善程度优于对照组(P<0.05)。治疗前,两组BDNF、NSE和IL-6水平比较,差异无统计学意义(P>0.05);治疗后,两组BDNF水平升高、NSE和IL-6水平降低,且观察组改善程度优于对照组(P<0.05)。治疗前,两组神经传导速度及波幅比较,差异无统计学意义(P>0.05);治疗后,两组神经传导速度及波幅水平升高,且观察组改善程度优于对照组(P<0.05)。结论:经颅磁刺激治疗儿童铅中毒临床效果显著,促进神经功能修复。Objective:To investigate the clinical effect of transcranial magnetic stimulation(TMS)on lead poisoning in children and its effect on nerve function.Methods:A total of 100 children with lead poisoning were selected as the research subjects,and divided into observation group(transcranial magnetic stimulation combined with metallothionein treatment,n=50)and control group(metallothionein treatment,n=50)according to different treatment methods.Blood levels of lead,zinc,iron,magnesium,calcium,copper,liver and kidney function indexes and blood routine were detected before and after treatment in both groups.Cognitive function,daily living ability and standing and walking ability were evaluated before and after treatment in both groups.The levels of brain-derived neurotrophic factor(BDNF),neuron-specific enolase(NSE)and interleukin-6(IL-6)before and after treatment were determined by enzym-linked immunosorbent assay.Results:Before treatment,there were no significant differences in blood lead,zinc,iron,magnesium,calcium and copper levels between the two groups(P>0.05).After treatment,blood lead levels were significantly decreased(P<0.05),zinc,iron and magnesium levels were significantly increased(P<0.05),and there were no significant differences in blood calcium and copper levels between the two groups(P>0.05).Before treatment,there were no significant differences in the levels of hemoglobin,red blood cell and white blood cell between the two groups(P>0.05).After treatment,the levels of hemoglobin were significantly increased(P<0.05),and the levels of red blood cell and white blood cell were not significantly different between the two groups(P>0.05).Before treatment,there were no significant differences in Gesell score,ADL score and GMFM-88 score between the two groups(P>0.05).After treatment,Gesell score,ADL score and GMFM-88 score were significantly increased between the two groups(P<0.05),and the improvement of observation group was better than that of control group(P<0.05).Before treatment,there were no significant di

关 键 词：儿童期铅中毒 经颅磁刺激 金属硫蛋白 神经功能 

分 类 号：R720.5[医药卫生—儿科] R595.2[医药卫生—临床医学]