金属硫蛋白联合纳米碳酸钙治疗铅中毒患儿对其智力及血清IgE、IGF-1的影响  

The effect of metallothionein combined with nano calcium carbonate on intelligence and serum IgE and IGF-1 in children with lead poisoning

作　　者：柏璐 常海霞[1] 王霞[1] 牛瑞杰 张静[1] 贾鹏宇 Bai Lu;Chang Haixia;Wang Xia;Niu Ruijie;Zhang Jing;Jia Pengyu(Department of Children's Health,Hebei Provincial Children's Hospital,Hebei Province,Shijiazhuang 050000,China)

机构地区：[1]河北省儿童医院儿童保健科,石家庄050000

出　　处：《疑难病杂志》2023年第7期740-744,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：2021年度河北省医学科学研究课题计划(20211385)。

摘　　要：目的观察金属硫蛋白(MT)联合纳米碳酸钙治疗铅中毒患儿对其智力及血清免疫球蛋白E(IgE)、胰岛素生长因子1(IGF-1)的影响。方法收集2020年10月—2022年11月河北省儿童医院儿童保健科收治的铅中毒患儿107例的临床资料。根据随机数字表法分为常规组(MT治疗)53例与研究组(MT联合纳米碳酸钙)54例。比较2组临床疗效及不良反应,检测治疗前后智力Gesell评分、实验室指标、肝肾功能指标。结果治疗后,研究组总有效率显著高于常规组(94.44%vs.79.25%,χ^(2)/P=5.434/0.020);2组患儿适应性、大运动、精细动作、语言及个人—社交评分均较治疗前增高,且研究组Gesell各项评分均显著高于常规组(t/P=5.708/<0.001、9.935/<0.001、4.931/<0.001、3.573/0.001、5.750/<0.001);2组血铅、IgE水平均较治疗前降低,血红蛋白、IGF-1水平均较治疗前增高,且研究组上述指标降低/增高程度均大于常规组(t/P=8.908/<0.001、29.612/<0.001、5.165/<0.001、10.613/<0.001)。2组治疗前后肝肾功能指标ALT、AST、SCr及BUN水平比较差异无统计学意义(P>0.05)。2组不良反应比较差异无统计学意义(P>0.05)。结论MT联合纳米碳酸钙治疗铅中毒患儿效果显著,可提高患儿智力水平,改善血清IgE、IGF-1水平,促进铅排放,且具有一定安全性。Objective To explore the effects of metallothionein(MT)combined with nano calcium carbonate on intelligence and serum immunoglobulin E(IgE)and insulin growth factor 1(IGF-1)in children with lead poisoning.Methods Collect clinical data of 107 children with lead poisoning admitted to the Children's Health Department of Hebei Children's Hospital from October 2020 to November 2022.According to different treatment plans,53 cases were divided into the conventional group(MT treatment)and 54 cases into the study group(MT combined with nano calcium carbonate).Compare the clinical efficacy and adverse reactions between the two groups,as well as the Gesell score,laboratory indicators,and liver and kidney function indicators before and after treatment.Results After treatment,the total effective rate of the study group was higher than that in the conventional group(94.44%vs.79.25%,χ^(2)/P=5.434/0.020);The adaptability,large motor,fine motor,language,and personal social scores of the two groups of children increased compared to before treatment,and the Gesell scores of the study group were higher than those of the conventional group(t/P=5.708/<0.001,9.935/<0.001,4.931/<0.001,3.573/0.001,5.750/<0.001).The blood lead and IgE levels in both groups decreased compared to before treatment,while hemoglobin and IGF-1 levels increased compared to before treatment.The degree of decrease/increase in the above indicators in the study group was greater than that in the conventional group(t/P=8.908/<0.001,29.612/<0.001,5.165/<0.001,10.613/<0.001).There was no statistically significant difference in the levels of ALT,AST,SCR,and BUN in liver and kidney function indicators between the two groups before and after treatment(P>0.05).There was no statistically significant difference in adverse reactions between the two groups(P>0.05).Conclusion The combination of MT and nano calcium carbonate has a significant therapeutic effect on children with lead poisoning,which can improve their intelligence level,improve serum IgE and IGF-1 levels,promote

关 键 词：铅中毒 金属硫蛋白 纳米碳酸钙 智力 免疫球蛋白E 胰岛素生长因子1 儿童 

分 类 号：R135.11[医药卫生—劳动卫生]