4—11岁儿童铅暴露与多动行为的关系.pdfVIP

4一ll 3 · 331· · 儿童保健· 4 11岁儿童铅暴露与多动行为的关系① 黄文沔 杨敬源 宋沈超 汪俊华 贵阳医学院流行病学教研室(贵州 贵阳) 550004 中国图书分类号 砒74 文献标识码 C 文章编号 l0o1-4411《2OO8)03-331-03 【摘 要】 目的：探讨不同血铅水平对儿童多动行为的影响及其差异。方法：采用严格质量控制的流行病学研究方法， 对贵阳市738例4—11岁儿童进行血铅水平测定，用Conners量表评价儿童多动行为。资料分析采用多因素方差分析和logistic回 归分析方法。结果：贵阳市儿童的血铅平均值为122．21 L，其中~250p,g／L者比例为4．7％。Conners评分表明具有多动行为 的儿童占调查人数的24．9％。随着血铅水平的增加，儿童的多动行为发生率明显增加 ( =37．69，P0．001)。以低血铅儿童 作为参照组，高血铅儿童发生多动行为的危险性显著升高，OR值分别增加到3．42和4．06。结论：血铅水平与儿童多动行为发 生的危险呈现明显剂量一效应关系。Conners量表评分可结合血铅检查结果，以排除其它因素的影响，有助于明确儿童多动行为 的原因。 【关键词】 血铅 儿童 流行病学 The relationship between lead exposure and hyperactivity among children aged 4— 1 1 years HUANG Wen—Yong，YANG Jing—Yuan，SONG Shen—Chao，et a1．Department ofEpidemiology，Guiyang Medical College， 550004，China [Abstract] Objective：To study the relationship between blood lead levels and hyperactivity among children and investigate the difference．Methods：The blood lead levels were measured among 738 children aged 4—1 1 years in Guiyang，using an epidemiological pro— tocol with sophisticated quality contro1．Behavioral effects among children exposed to lead were assessed by Conners Rating Scales for Teach— ers and Parents．Data analysis was performed by using multivariate analysis of variance and non—conditional logistic regression．Results：The mean blood lead level was 122．21 L，and 4．7％ blood lead level of children were 250 L The proportion of hyperactivity WaS 24．9％among children．The blood lead levels ofchildren were associatedwith hyperactivity =37．69，P0．001)．Compared with ref- erence group，children with high lead level had a high hazard(OR 3．42 and 4．06，respectively)．Conclusion：The hazard of hyperactivi— ty in different blood lead levels shows a dose—effect relationship．To exclude the actions from other confounding factors，Conners scor