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背景:虽然许多研究提出了听脑干反应在检查新生儿和婴幼儿听觉通路及判断脑干功能中具有重要价值。但孕期低水平铅暴露与婴儿是否有听脑干反应的结果异常的关系尚缺乏足够的证据。目的:通过听脑干反应检查观察孕期低水平铅暴露对婴儿期听力发育的影响。设计:随机、双盲对照研究。单位:南京医科大学第二附属医院儿童保健研究中心,耳鼻喉科。对象:1999-04/12在南京医科大学第二附属医院产科住院分娩的237名产妇及所生240婴儿,除外高危妊娠。根据产母自愿的原则,纳入215例产母、婴儿出生后在儿童保健研究中心随访检查,配对资料完整的54例6月龄婴儿。方法:检查6月龄婴儿的听性脑干反应(auditorybrainstemresponse,ARB),检测母产时血铅、脐血铅及婴儿血铅水平,进行两者间相关分析。主要观察指标:①脐血铅水平与母产时血铅水平相关性。②婴儿ABR的各波潜伏期及左、右耳潜伏期比较。③ABR的各波间期及左、右耳波间期比较。结果:6月龄婴儿左耳ABRI,III,V波潜伏期犤(1.97±0.49),(5.22±0.51),(6.05±0.54)ms犦明显长于右耳犤(1.85±0.53),(5.09±0.60),(5.91±0.47)ms犦(t=3.07,2.68,2.56,P<0.05～0.01);脐血铅水平与右耳的Ⅰ,Ⅲ,Ⅴ波潜伏期明显相关(r=0.624,0.592,0.602,P<0.05)。结论:胎儿期低水平的铅暴露可?
Background: Although many studies have suggested that brainstem response is of great value in examining the auditory pathways of newborns and infants and judging brainstem function. However, the relationship between the low level of lead exposure during pregnancy and the abnormality of the brainstem response to the infant still lacks sufficient evidence. Objective: To observe the effect of low level lead exposure during pregnancy on the hearing development in infancy through the auditory brainstem response. Design: Randomized, double-blind, controlled study. Unit: Second Affiliated Hospital of Nanjing Medical University Child Health Research Center, ENT. PARTICIPANTS: 237 maternal and 240 infants born in the obstetrics and gynecology department of the Second Affiliated Hospital of Nanjing Medical University from April to December 1999, except for those at high risk of pregnancy. According to the principle of giving birth to mother voluntarily, 215 mothers and their infants were enrolled in the follow-up inspection of CHCs and 54 pairs of 6-month-old infants with complete data were matched. Methods: Auditory brainstem response (ARB) was examined in 6-month-old infants. Blood lead levels, cord blood lead levels and infant blood lead levels were measured and their correlations were analyzed. MAIN OUTCOME MEASURES: ① The correlation between cord blood lead level and blood lead level in mother’s motherhood. ② infant ABR wave latency and left and right ear latency comparison. ③ABR wave interval and left and right ear wave interval comparison. Results: The latency of ABRI, III and V wave in left ear of 6 month old baby was significantly longer than that of right ear (1.85 ± 0.53), (5.09 ± 0.60), (5.22 ± 0.51) and (6.05 ± 0.54) (5.91 ± 0.47) ms 犦 (t = 3.07,2.68,2.56, P <0.05-0.01). The lead levels in umbilical cord were significantly correlated with the latency of Ⅰ, Ⅲ and Ⅴ waves in the right ear (r = 0.624, 0.592 and 0.602, , P <0.05). Conclusion: Low levels of fetal lead exposure can be?