【摘要】 目的:探讨幼儿反复呼吸道感染(RRTI)血铅水平分布与免疫系统机能变化的关系。方法:自2005.6~12月,从我院收治的RRTI幼儿中随机筛选80例病例,在RRTI发作期,用原子吸收分光光度法进行血铅测定,依照1991年美国疾病控制与预防中心(USCDC)制定的儿童铅中毒诊断分级标准,将受试病例分为6级;用流式细胞仪检测患儿T淋巴细胞亚群,B淋巴细胞亚群,NK细胞;用免疫比浊法测定免疫球蛋白IgAI、gGI、gM水平。对6组患儿进行常规加驱铅治疗,驱铅治疗满一个疗程,分别测定血铅水平,检测IgAI、gGI、gM,T淋巴细胞亚群、B淋巴细胞亚群、NK细胞。结果:(1)80例受试病例治疗前血铅水平均在Ⅰ~Ⅲ级之间,治疗后血铅水平均在Ⅰ~Ⅱ级之间,病例分布随着血铅水平增高逐渐减少。(2)治疗前受试病例IgAI、gG、IgM,T淋巴细胞亚群、B淋巴细胞亚群、NK细胞样本均数分别进行F检验,其中IgAI、gG、T淋巴细胞亚群、B淋巴细胞亚群四项免疫指标P<0.05,存在差异,而IgM、NK细胞P>0.05,不存在差异。(3)治疗前、后,血铅水平分别与对应的免疫指标IgAI、gG、T淋巴细胞亚群、B淋巴细胞亚群进行相关分析,相关系数进行t检验,显示二者之间存在较明显的负相关(P<0.05)。结论:(1)80例受试病例均处于铅暴露中,发作期血铅水平病例以Ⅰ级居多,占63%,Ⅳ~Ⅵ级未见,近似于正偏态分布;治疗后,Ⅰ级占96.25%,Ⅲ~Ⅵ级未见。(2)治疗前,患儿血铅水平增高,IgAI、gG、T淋巴细胞亚群、B淋巴细胞亚群含量趋于降低,治疗后,血铅水平降低,以上四项免疫指标升高。说明幼儿患反复呼吸道感染与铅暴露及其所致的免疫机能抑制有关。更多还原

【Abstract】 Objective:To investigate the relationship between the distribution of the blood-lead level in infant with repeated respiratory tube infection(RRTI) and the function chang of the immune system.Methods: From June to December 2005,the lead levels in blood of the 80 cases with RRTI who were chosen randomly from the patients treated in our hospital,had been determined by the atom absorbing and separating lightmeter in the outbreak period of time.According to the diagnose classification standard of lead toxicity for children formulated by the USCDC in 1991,the tested cases were divided and the examining items were classified into six levels,T lymphocyte subgroup(TLS)、B lymphocyte subgroup(BLS) and NK cell(NKC) by the fluent style cell instrument and the led levels of the immune globin IgA、IgG、IgM were tested by the immune comparative muddy degree method.The six groups were treated by the conventional plus removing-lead treatment methods.The removing-lead treatment continued one course,then respectively tested the lead level in blood,measured the immune globin IgA、IgG、IgM,TLS、BLS、NKC.Results:(1) Before treatment,the lead content in blood of 80 tested cases were all between Ⅰ and Ⅲ levels.After treatment the lead content in blood were all betweenⅠand Ⅱ level.The cases reduced with the content of lead in blood gradually increasing.(2)The test F of the stylebook average was respectively going along with the IgA、IgG、IgM、TLS、BLS、NKC before and after treatment,of which the tested results of the IgA、IgG、TLS、BLS showed P<0.05,there was difference.But the test F of IgM、NKC showed P>0.05,there was no difference.(3) Before and after treatment,the lead contents in blood was analyzed with the corresponding data:IgA、IgG、TLS、BLS respectively,and the correlative coefficient T was analyzed as well.(P<0.05),showing that there were comparatively abvious negative correlation.Comclusion:(1) 80 tested cases were all in lead exposure before treatment,of which level Ⅰwas accounted for the first position,occupying 63 percent.Level ⅣtoⅥ was not found.The distributing of the lead level in blood presented a approximate positive partial shape.After treatment,level Ⅰaccounted for 96.25 percent,level Ⅲ to Ⅵ was not found.(2) Before treatment,when the lead content in blood increased,the IgA、IgG、TLS、BLS reduced,after treatment,when the lead content in blood reduced,the IgA、IgG、TLS、BLS rised,which explain that there are certain relation between the RRTI with the lead level in blood and the restrain of the immune function caused by the exposure of lead.更多还原