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【目的】探讨出生前100μg/L以下剂量铅暴露对婴儿6月龄时智力和行为发育的影响。【方法】以出生前孕早期和晚期孕妇血铅低于100μg/L的婴儿为研究对象,在其6月龄时用Bayley婴幼儿发育量表评价智力发育和精神运动发育。根据孕早期和晚期血铅的P25、P50和P75为界值,将婴儿分为相对高、中、低铅组,比较不同组间智力(mental development index,MDI)和行为发育指数(psychomotor development index,PDI)差异。【结果】婴儿6月龄时MDI和PDI均随出生前血铅水平的升高呈现下降趋势。以P25和P50为界值分组时,相对高铅组婴儿PDI均低于相对低铅组,且差异具有统计学意义(P<0.05);以P75为界值时,组间婴儿PDI未见明显差异。各分组间婴儿MDI差异均无统计学意义(P>0.05)。纳入孕妇年龄、文化因素分析发现,孕早期和晚期血铅在P50(31.15μg/L和37.58μg/L)以上的婴儿其PDI较其他婴儿PDI低4.48分;孕早期和晚期血铅水平在P25(24.0μg/L和29.8μg/L)以上的婴儿,其PDI较其他婴儿PDI低6.51分,差异均有统计学意义。【结论】出生前100μg/L剂量以下铅暴露对婴儿发育有影响,特别是对婴儿6月龄时PDI影响更为显著。
【Objective】 To investigate the effects of lead exposure of 100 μg / L before birth on the mental and behavioral development of infants at 6 months of age. 【Methods】 Infants with blood lead less than 100 μg / L in the first trimester and the second trimester of pregnancy were enrolled in this study. The development of mental and psychomotor development was evaluated at 6 months of age using the Bayley Infant Developmental Scale. According to the levels of P25, P50 and P75 in early and late pregnancy, the infants were divided into relatively high, medium and low lead groups, and mental development index (MDI) and psychomotor development index , PDI) difference. 【Results】 The MDI and PDI of 6-month-old infants decreased with the increase of blood lead levels before birth. When the P25 and P50 values were grouped, the PDI of infants in the relatively high lead group was lower than that of the relatively low lead group (P <0.05), and no significant difference was found in the PDI between the infants difference. There was no significant difference in MDI among infants (P> 0.05). Including the age of pregnant women, cultural factors analysis found that the first and second trimester blood lead in P50 (31.15μg / L and 37.58μg / L) above the PDI PDI 4.48 points lower than other infants; first trimester and late blood lead levels in P25 (24.0μg / L and 29.8μg / L), the PDI was 6.51 points lower than that of other infants, the differences were statistically significant. 【Conclusion】 Exposure to lead below 100 μg / L before birth has an impact on infant development, especially on infant PDI at 6 months of age.