探討學齡兒童尿液中三聚氰胺與微白蛋白濃度的相關性

中文摘要由於中國的三聚氰胺毒奶粉事件，導致嬰幼兒腎結石及嚴重的腎臟問題，經過媒體報導後，引起國際上的重視。最新的研究顯示，在低劑量的三聚氰胺暴露下亦會提高成人尿路結石的風險；然而，目前尚未有足夠的研究說明低劑量的三聚氰胺暴露對於兒童的健康影響。三聚氰胺在日常生活中的應用非常的廣泛，包括廚具、餐具、塑料、黏著劑以及玩具塗料，若在不知情的狀況下購買或使用，三聚氰胺可能從這些產品釋放到食物當中，當兒童長期的暴露下，是否會有腎臟病變的產生，是值得研究的課題。在三聚氰胺毒奶粉事件研究中，除了利用放射線檢查結石外，亦利用超音波做檢查，對於腎功能除了血液檢查外，最方便方便就是非侵入性的尿液檢測，當時的研究方法皆以隨機單點尿液檢測三聚氰胺濃度及生化檢測，並未有人收集測量24小時的尿液。因此我們針對24小時的尿液收集並與隨機單點尿液檢測比較學童尿液中三聚氰胺與微白蛋白濃度。23位學童尿液中三聚氰胺與微白蛋白經過校正後，各別檢測在第一天與第二天早上的第一泡尿液(spot 1與spot 2)以及8小時與24小時，皆存有顯著性相關(P＜0.05)；另外三聚氰胺與微白蛋白相互比較在spot 1與spot 2以及8小時與24小時，則不具顯著性相關。實證結果顯示，三聚氰胺隨機單點尿液的檢查是可行的，但最好能在每天早晨定點收集，以避免身體代謝因子干擾，而微白蛋白亦相同受飲水、運動等因子影響變易性較大，所以量測所得的結果資料皆須經由校正後再進行分析，如此才能得到真值。本研究目前尚無發現尿液中三聚氰胺的濃度與尿液中微白蛋白具有相關性，仍須進一步的研究來加以探討。【關鍵詞】三聚氰胺、微白蛋白、學齡兒童

關鍵字

三聚氰胺；微白蛋白；學齡兒童

並列摘要

Abstract The outbreak of melamine-tainted infant formula has raised concerns about causing kidney stones and severe kidney problems in young children worldwide. Recently, epidemiological studies show that exposure to low doses of melamine increased the risk of adult urinary tract stones. To date there is limited data regarding the effects of low doses of melamine exposure and children's health. Melamine, a widely used chemical found in many daily use products, i.e., daily life utensils, cutlery, plastic, adhesive and paint toys, which may be the sources of the presence of urinary melamine. However, it is not known whether exposure to melmaine in our daily life might cause kidney problems in children. In most of the studies in this incident, they use renal ultrasonography to screen stone type and further cross checked by radiologist. For the kidney function assessment, in addition to the blood measurement, non-invasive urine measurement is more convenience. However, most of the studies use random urine to measure melamine exposure and clinical measurement of kidney function. This study was conducted 24 hour urine and random urine to creatinine ratio of urinary melmaine as melamine exposure and microalbumin as kidney function assessment among 23 children. The results show that whether urinary melamine or microalbumin, the first morning urine of two days (spot1 and spot2), and 8 hours and 24 hours had significant correlation (p<0.05); however, when we compared the urinary melamine and microalbumin in spot1, spot2, or 8 hours and 24 hours, the results show no significant correlation. The empirical results show that the random urine collection to examine melamine is feasible, preferalby in the morning to avoid the interference of the metabolism of the body factor; and for microalbumin is also varience by the water, exercise and other factors. Therefore, the reuslts should correct creatinine and then analyzed to get the true value. These data suggest that we need further study to explore the relationship between urinary melamine and microalbumin. Keywords：Melamine 、Microalbumin 、School children