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目的探讨工业污染地区小学生的汞暴露水平和神经行为功能之间的关系,分析影响汞暴露与神经行为功能的因素。方法于2012—2014年选取位于我国不同方位的6个地区(河北省肃宁县、甘肃省兰州市、辽宁省铁岭市、广西壮族自治区南宁市、河南省新乡市和宁夏回族自治区石嘴山市)作为研究地点,选取共1 013名年龄在8~12岁之间的小学生作为研究对象,收集研究对象的即时尿样和头发样品检测汞含量,采用神经行为测试评价系统(NES)和平衡测试评价研究对象的神经行为功能,并采用问卷调查的方式收集研究对象的年龄、性别、家庭情况、饮食情况等基本信息。结果研究对象的发汞和尿肌酐调整的尿汞水平呈正相关(rs=0.211,P<0.01)。在汞暴露影响因素的logistic回归分析中,每周食用肉类频次较多的儿童具有较高尿汞水平的风险(OR=1.855,95%CI:1.168~2.950)和较高发汞水平的风险(OR=2.309,95%CI:1.214~4.392)。具有较高发汞水平的风险也与每周食用稻米频次呈正向关联(OR=1.755,95%CI:1.101~2.798)。在神经行为功能影响因素的logistic回归分析中,发汞水平较高的研究对象其震颤强度有增加的风险(OR=2.086,95%CI:0.956~4.555),左手平均反应时间有延长的风险(OR=1.561,95%CI:0.930~2.620),尿汞水平较高的研究对象其右手震颤中心频率有增加的风险(OR=1.151,95%CI:1.000~1.323)。结论食用稻米较多的研究对象倾向于具有较高的发汞水平,体内汞水平较高可能影响神经行为功能。
Objective To explore the relationship between mercury exposure level and neurobehavioral function of primary school students in industrial pollution area and to analyze the factors that affect mercury exposure and neurobehavioral function. Methods Six regions (Suning County of Hebei Province, Lanzhou City of Gansu Province, Tieling City of Liaoning Province, Nanning City of Guangxi Zhuang Autonomous Region, Xinxiang City of Henan Province and Shizuishan City of Ningxia Hui Autonomous Region) were selected from 2012 to 2014 in different directions in China. A total of 1 013 primary schoolchildren between the ages of 8 and 12 were enrolled in this study. Mercury concentrations in real-time urine samples and hair samples were collected. Neurobehavioral assessment system (NES) and balance test were used to assess the subjects The neurobehavioral function, and the use of questionnaires to collect the subjects of age, gender, family circumstances, diet and other basic information. Results There was a positive correlation between hair mercury and urinary creatinine adjusted urinary mercury levels (rs = 0.211, P <0.01). In the logistic regression analysis of the factors influencing mercury exposure, children with higher frequency of meat consumption per week had higher urinary mercury levels (OR = 1.855, 95% CI: 1.168-2.950) and higher risk of mercury levels ( OR = 2.309, 95% CI: 1.214 ~ 4.392). Risks associated with higher mercury levels were also positively correlated with the weekly frequency of edible rice (OR = 1.755, 95% CI: 1.101-2.798). In the logistic regression analysis of the influencing factors of neurobehavioral function, subjects with higher levels of mercury had an increased risk of tremor (OR = 2.086, 95% CI: 0.956-4.555) and prolonged left-handed mean response time ( OR = 1.561, 95% CI: 0.930-2.620). Patients with higher urinary mercury levels had an increased risk of having right heart tremor central frequencies (OR = 1.151, 95% CI: 1.000-1.323). Conclusions More subjects who eat rice tend to have higher mercury levels, and higher levels of mercury may affect neurobehavioral function.