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目的探讨哈尔滨市大气污染对儿童唾液溶菌酶含量及肺功能的影响。方法于2014—2015年在哈尔滨市两个城区测定大气PM2.5浓度,分别在距离监测点500~1 000 m处选择1所小学,对602名儿童进行肺功能、唾液溶菌酶测定及问卷调查。结果污染区(道外区)儿童唾液溶菌酶含量及肺功能指标最大通气量(MVV)低于清洁区(道里区),阻塞指数(OI)高于清洁区,差异均有统计学意义(P<0.05)。污染区不同年级儿童肺活量(VC)、用力肺活量(FVC)、中间呼气流量(MMF)、峰值流量(PEF)、75%用力呼气流量(FEF75)、MVV等肺功能指标随着年级的增加而升高,清洁区不同年级儿童VC、FVC、1 s用力呼气容积(FEV1)、OI、MVV等肺功能指标随着年级的增加而升高,差异均有统计学意义(P<0.05)。污染区儿童唾液溶菌酶含量均低于同年级的清洁区儿童;污染区3年级儿童肺功能指标OI高于清洁区,MVV低于清洁区;污染区4年级儿童肺功能指标VC、FVC、FEV1、FEF75、MVV均低于清洁区;污染区5年级儿童肺功能指标FVC低于清洁区;上述差异均有统计学意义(P<0.05)。污染区男生肺功能指标VC、FVC、FEV1、MMF、PEF、FEF75、MVV均高于女生,OI低于女生,差异有统计学意义(P<0.05)。清洁区男生肺功能指标VC、FEV1、MMF、PEF、FEF75、MVV均高于女生,差异有统计学意义(P<0.05)。污染区儿童唾液溶菌酶含量均低于清洁区同性别学生;污染区男生肺功能指标OI低于清洁区,污染区女生肺功能指标FVC、MVV低于清洁区;上述差异均有统计学意义(P<0.05)。偏相关分析结果显示,大气PM2.5浓度与唾液溶菌酶含量呈负相关,与肺功能指标VC、FVC、MVV呈负相关,与OI呈正相关,均有统计学意义(P<0.05)。结论大气污染可降低唾液溶菌酶含量及儿童肺通气功能,应注意防范。
Objective To investigate the effects of air pollution on the salivary lysozyme content and lung function of children in Harbin. Methods Atmospheric PM2.5 concentrations were determined in two urban districts of Harbin in 2014-2015. One primary school was selected at 500-1,000 m from the monitoring point, and lung function, saliva lysozyme and questionnaire . Results The salivary lysozyme content and pulmonary function index MVV in the contaminated area were lower than those in the clean area (Daoli area), and the occlusion index (OI) was higher than that in the clean area (P < 0.05). The pulmonary function indexes such as vital capacity (VC), forced vital capacity (FVC), middle expiratory flow (MMF), peak flow (PEF), 75% forced expiratory flow (FEF75) and MVV in children of different grades in the polluted area increased with the increase of grade However, the indexes of pulmonary function such as VC, FVC, FEV1, OI and MVV of children in different grade in the elevated area increased with the increase of grade, the difference was statistically significant (P <0.05) . The levels of salivary lysozyme in children in the contaminated area were lower than those in the same grade of clean area. The OI of pulmonary function indexes in the third grade children in the contaminated area were higher than those in the clean area and the MVV was lower than the clean area. The pulmonary function indexes VC, FVC, FEV1 , FEF75 and MVV were lower than those in the clean area. The FVC of the fifth grade children in the contaminated area was lower than that in the clean area. The differences were statistically significant (P <0.05). The pulmonary function indexes of VC, FVC, FEV1, MMF, PEF, FEF75 and MVV in the polluted area were all higher than those in the girls, and the OI was lower than that in the girls. The difference was statistically significant (P <0.05). The pulmonary function indexes of boys in clean area were higher than girls in terms of VC, FEV1, MMF, PEF, FEF75 and MVV, the difference was statistically significant (P <0.05). The salivary lysozyme contents of children in the polluted area were lower than those of the same gender in the clean area. The OI of lung function in boys in the polluted area was lower than that in the clean area. The FVC and MVV in the polluted area were lower than those in the clean area. The difference was statistically significant P <0.05). Partial correlation analysis showed that PM2.5 concentration in the air was negatively correlated with salivary lysozyme content, negatively correlated with pulmonary function parameters VC, FVC and MVV, and positively correlated with OI, both of which were statistically significant (P <0.05). Conclusion Air pollution can reduce salivary lysozyme content and pulmonary ventilation in children, should pay attention to prevention.