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目的探讨儿童铅暴露与支气管哮喘(哮喘)的关系。方法选择2011年2月-2012年2月在百色市妇幼保健院和右江民族医学院附属医院儿童哮喘门诊就诊的哮喘儿童126例。男66例,女60例;年龄2～8(6.0±2.1)岁。根据病情,将哮喘儿童分为轻度发作(69例)、中度发作(33例)和重度发作(24例)。健康对照组选择同期在百色市妇幼保健院和右江民族医学院附属医院儿科体检的健康儿童118例。男60例,女58例;年龄2～9(6.0±2.8)岁。无哮喘及其他呼吸系统疾病,其本人和家族成员无变应性疾病及变态反应性疾病史。采用原子吸收光谱法检测哮喘儿童血铅水平,ELISA法检测其血清总IgE,静脉血常规分类法计数外周血嗜酸性粒细胞(EOS),并与健康对照组比较。结果哮喘儿童组血铅、总IgE及EOS计数均明显高于健康对照组,差异均有统计学意义(Pa<0.001),不同哮喘发作程度患儿血铅、总IgE水平及EOS计数差异均有统计学意义(Pa=0.001),重度发作组血铅、总IgE水平及EOS计数高于中度发作组,中度发作组高于轻度发作组,差异均有统计学意义(Pa<0.001)。哮喘儿童血铅与血清总IgE、EOS计数均呈显著正相关(r=0.879、0.823,Pa<0.01)。结论铅暴露导致与哮喘有关的免疫损伤是引起儿童哮喘高IgE水平并诱发哮喘的重要因素,并可能增加儿童哮喘的发病风险。
Objective To explore the relationship between lead exposure in children and bronchial asthma (asthma). Methods A total of 126 asthmatic children were selected from the Children’s Asthma Clinic of Baise MCH and the Youjiang Medical College Affiliated Hospital from February 2011 to February 2012. There were 66 males and 60 females, ranging in age from 2 to 8 (6.0 ± 2.1) years. According to the condition, children with asthma were divided into mild attack (69 cases), moderate attack (33 cases) and severe attack (24 cases). Healthy control group choose the same period in Baise Maternal and Child Health Hospital and Youjiang Medical College Affiliated Hospital pediatric physical examination of 118 healthy children. 60 males and 58 females; aged 2 to 9 (6.0 ± 2.8) years old. No history of asthma and other respiratory diseases, no allergic diseases and allergic diseases in themselves and in family members. Blood lead levels were measured by atomic absorption spectrometry in children with asthma, total serum IgE was detected by ELISA, peripheral blood eosinophils (EOS) were counted by venous blood routine classification, and compared with healthy controls. Results The levels of blood lead, total IgE and EOS in children with asthma were significantly higher than those in healthy controls (P <0.001). The levels of blood lead, total IgE, and EOS in children with asthma attack were significantly different (Pa = 0.001). The level of blood lead, total IgE and count of EOS in severe episode group were higher than those in moderate episode group and those in moderate episode group were higher than in mild episode group (P <0.001) . Blood lead levels in asthmatic children were positively correlated with total serum IgE and EOS count (r = 0.879,0.823, Pa <0.01). Conclusion Lead exposure leads to asthma-related immunological injury is an important factor in causing high IgE levels and asthma in children and may increase the risk of asthma in children.