血液金屬濃度、砷甲基化能力與發展遲緩兒童

The Concentration of Blood Metals, Arsenic Methylation Capability and Developmental Delay Children

黃筱蓉(Shiau-Rung Huang)

指導教授 ： 薛玉梅

臺北醫學大學/公共衛生暨營養學院/醫務管理學研究所/碩士(2012年)

https://doi.org/10.6831/TMU.2012.00059

摘要

鉛、汞與砷已被認為對人體有害，在人類生長時期受到鉛、汞與砷的暴露將導致不良健康影響。為瞭解血液鉛與汞濃度以及尿液砷濃度與砷甲基化能力對兒童發展遲緩之相關性，本研究於台北市新光吳火獅紀念醫院復健科收取經由醫師診斷判定為發展遲緩兒童共84名，此外同時收取正常兒童共87名。由受過訓練之訪員向研究對象說明研究目的並經由研究對象同意簽署受試者同意書後，利用結構式問卷詢問研究對象基本人口學資料並收取血液檢體5 ml 與尿液檢體25 ml。血液檢體經過微波消化器進行消化後，利用感應藕合電漿質譜儀進行金屬鉛與汞的濃度測定。尿液檢體經由碳18管過濾後，利用高效能液相層析儀串連氫化器與原子吸收光譜儀進行尿液砷物種分析。本研究的發展遲緩兒童血液鉛與汞濃度均高於正常兒童，此外尿液砷物種濃度也高於非發展遲兒童，發展遲緩兒童砷甲基化能力低於正常兒童。隨著血液鉛濃度與尿液砷物種濃度上升，發展遲緩的危險對比值增加，兒童砷甲基化能力越好則發展遲緩的危險對比值下降。將血液鉛濃度與尿液總砷濃度進行聯合效應分析，血液鉛濃度較高且尿液砷濃度較高者其危險對比值比血液鉛濃度較低且尿液總砷濃度較低者顯著增加危險對比值，危險對比值與95%信賴區間為26.76 ( 2.68 - 267.09 )。

關鍵字

鉛 ； 汞 ； 砷物種 ； 砷甲基化能力 ； 發展遲緩

並列摘要

Lead, mercury and arsenic are well-known toxic elements. They can cause adverse effects during the period of development in human. To explore the relationship between blood lead and mercury level, urinary arsenic species levels, arsenic methylation capability and developmental delays, we carried out a cross-sectional study at Shin-Kong Ho-Su Memorial Hospital in Taipei City. We recruited 84 children who were diagnozed with developmental delays by physician from the Department of Rehabilitation and 87 normal children recruited from the Department of Pediatrics. Well-trained assistants performed the standardized personal interview based on a structured questionnaire for study subjects and collected their biospecmen after they provided their inform consents. Information obtained from the interview included demographic characteristics, educational level and occupation of parents, personal and family disease histories as well as children function, health condition, and quality of life. Blood of study subjects were determined for the lead and mercury level using inductively coupled plasma mass spectrometry. Urine were analyzed for the arsenic species using high performance liquid chromatography linked hydride generator and atomic absorption spectrometry. We found developmental delay children’s blood had higher concentration of lead and mercury than normal children. The urine concentrations of arsenic species were higher and the arsenic methylation capability was lower in developmental delay children than in normal children. Furthermore, we also analyzed the joint effect of blood lead level and urinary total arsenic concentration on developmental delay. We found that participants had high blood lead level and high urinary total arsenic concentration had significantly higher odds ratio (OR) of developmental delay than those with low blood lead level and low urinary total arsenic concentration, and OR and 95% confidence interval was 26.76 ( 2.68-267.09 ).

並列關鍵字

Lead ； Mercury ； Arsenic species ； Arsenic Methylation Capability ； Developmental Delay

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