摘要
目的探讨孕妇低血铅暴露与胎儿脐血铅相关性,并分析对胎儿骨代谢的影响。方法收集2016年8月—11月清远市妇幼保健院产科分娩产妇临床资料,根据孕妇分娩时血铅水平分为相对高血铅组(45例)和相对低血铅组(17例)。以Pearson相关分别分析孕妇血铅水平与胎儿脐血铅、新生儿出生时体重、身高、头围、胸围的相关性。比较两组胎儿体检指标和骨代谢指标差异。结果孕妇62例血铅水平分布范围(28.9~187.52)μg/L,中位数为95.85μg/L;62例胎儿脐血血铅平均水平为(76.19±36.84)μg/L。孕妇血铅与胎儿脐血铅显著正相关(r=0.760,P=0.000),与新生儿头围呈负相关(r=-0.305,P=0.034)。两组新生儿出生时体检指标差异均无统计学意义(P>0.05)。相对高铅组新生儿的血清碱性磷酸酶为(173.55±56.13)U/L,高于相对低血铅组(134.46±52.08)U/L,差异有统计学意义(P<0.05)。相对高铅组新生儿血清骨钙素和血钙水平分别为(11.68±5.96)ng/m L和(0.325±0.04)mmol/L,均低于相对低铅组(18.14±5.12 U/L)和(0.359±0.05 U/L),差异均有统计学意义(P<0.05)。结论孕妇血铅值越高,胎儿脐血铅浓度也越高,孕妇低血铅暴露可直接影响新生儿骨代谢。
Objective To study the correlation between the low blood lead exposure in pregnant women and fetal umbilical cord blood lead, and its effect on fetal bone metabolism. Methods The clinical data of obstetric delivery women in the hospital, from August to November in 2016, were collected. According to the levels of blood lead during the delivery, the pregnant women were divided into a high blood lead group （45 cases） and a low blood lead group （17 cases）. Pearson correlation analysis was used to analyze the correlation between the maternal blood lead levels and fetal umbilical cord blood lead levels, newborn birth weight, height, head circumference, chest circumference,respectively. Fetal physical examination indicators and bone metabolic indicators were compared between two groups. Results Among the 62 pregnant women, the median blood lead level was 95.85μg/L with a distribution range of 28.98 μg/L to 187.52 μg/L. The average fetal cord blood level was （76.19± 36.84） μg/L of the 62 fetal cases. The blood lead level in pregnant women was positively correlated with the fetal umbilical cord blood lead （r=0.760, P=0.000）, and was negatively correlated with the neonatal head circumference （r=-0.305, P=0.034）. There was no significant difference between the two groups in the physical examination indexes of newborns at birth （P〉 0.05）. The serum alkaline phosphatase （173.55±56.13） U/L in the high-lead group was higher than that （134.46±52.08） U/ L） in the low lead group, and the difference was statistically significant （P〈0.05）. The serum osteocalcin level （11.68±5.96） ng/ mL and serum calcium level （0.325±0.04） mmol/L in the high-lead group were lower than those （18.14±5.12） U/L and （0.359± 0.05） U/L in the low-lead group, and the difference was statistically significant （P〈0.05）. Conclusion The higher the blood lead value of pregnant women, the higher the lead concentration of umbilical cord blood, and the lower blood lead exposure of pregnant women can directly influence the newborn bone metabolism.
作者
刘玉线
龙辉
陈瑞琼
LIU Yuxian;LONG Hui;CHEN Ruiqiong(Department of lnspection,Qingyuan Maternal and Child Health Hospital,Qingyuan,Guangdong 511500,China)
出处
《中国热带医学》
CAS
2018年第7期705-707,共3页
China Tropical Medicine
基金
清远市科技计划项目(No.2016B081)
关键词
妊娠
新生儿
铅暴露
骨代谢
pregnancy
newborn
lead exposure
bone metabolism
