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目的分析新生儿不同铅暴露水平与脑源性神经生长因子含量及神经行为的相关性。方法选择医院2014年2月-2016年7月足月顺产脐血铅含量≥0.48μmol/L的高铅暴露新生儿41例为观察组,另选同期足月顺产脐血铅含量<0.48μmol/L的低铅暴露新生儿45例为对照组,比较2组新生儿神经行为测定(NBNA)评分及脑源性神经生长因子(BDNF)含量,分析血铅水平与新生儿NBNA评分及BDNF水平的相关性。结果观察组新生儿NBNA评分中行为能力、主动肌张力、被动肌张力、一般反应评分均低于对照组(P<0.05),2组原始反射评分差异无统计学意义(P>0.05);观察组新生儿脐血BDNF含量明显高于对照组,差异有统计学意义(P<0.05);经线性相关性分析显示,高铅暴露新生儿脐血BDNF水平与NBNA评分中的被动肌张力、主动肌张力、行为能力、一般反应评分呈负相关性(r分别为-0.25、-0.41、-0.33、-0.36,P<0.05)。结论高铅暴露水平可能导致新生儿神经行为损伤,而BDNF水平可作为铅引发新生儿神经行为损伤的标志物。
Objective To analyze the correlation between different levels of lead exposure in neonates and brain-derived neurotrophic factor and neurobehavioral changes. METHODS: Forty-one newborns with high-lead exposure of ≥0.48 μmol / L umbilical cord blood from January 2014 to July 2016 were enrolled in the study group. The lead content in term full-term cesarean section was <0.48 μmol / L neonatal low-lead exposure in 45 newborns as control group, compared neonatal neurobehavioral determination (NBNA) score and brain-derived nerve growth factor (BDNF) content, blood lead levels and neonatal NBNA score and BDNF levels Correlation. Results The NBNA scores of the observation group were significantly lower than those of the control group (P <0.05), while the scores of active muscle tension, passive muscle tension and general response were lower in observation group than those in control group (P> 0.05) The levels of BDNF in neonatal cord blood were significantly higher than those in control group (P <0.05). The linear correlation analysis showed that BDNF level in neonatal cord blood and passive muscle tension in NBNA score Muscle tension, capacity, and general response scores were negatively correlated (r = -0.25, -0.41, -0.33, -0.36, P <0.05, respectively). Conclusion High exposure to lead may lead to neonatal neurobehavioral injury, while BDNF may be used as a marker of lead-induced neonatal neurobehavioral injury.