A 50-YEAR FOLLOW-UP OF CHILDHOOD PLUMBISM - HYPERTENSION, RENAL-FUNCTION, AND HEMOGLOBIN LEVELS AMONG SURVIVORS
A 50-YEAR FOLLOW-UP OF CHILDHOOD PLUMBISM - HYPERTENSION, RENAL-FUNCTION, AND HEMOGLOBIN LEVELS AMONG SURVIVORS
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DOI：
10.1001/archpedi.1991.02160060099029
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发表时间：
1991-06-01
影响因子：
--
通讯作者：
HU, H
中科院分区：
文献类型：
--
作者：
HU, H
这项试点研究确定了1930年至1942年期间有充分记录的铅中毒受试者，共192名。 72名幸存者中有35名追溯到波士顿地区的地址，22名年龄，性别，种族和邻里匹配的对照组被招募到临床研究中。 一名匹配的铅中毒患者肾功能严重异常，血铅水平升高，原因不明。 在剩下的21对配对中，高血压的风险在铅中毒的受试者中明显更高（相对风险为7.0; 95%可信区间为1.2 - 42.3）。 然而，与性别和年龄预测的肌酐清除率相比，铅中毒受试者的平均校正肌酐清除率显著高于对照组和超常水平。 铅中毒患者的血红蛋白浓度和红细胞压积明显低于对照组。 两组的血铅和血清肌酐水平均较低。 这些结果表明，儿童期铅中毒的幸存者在肌酐清除率高于正常值的情况下，发生临床显著性高血压的风险增加。
A group of 192 subjects with well-documented lead poisoning in 1930 to 1942 were identified in this pilot study. Thirty-five of 72 survivors traced to a Boston area address and 22 age-, sex-, race-, and neighborhood-matched controls were recruited into a clinical study. One matched subject with plumbism had grossly abnormal renal function and an elevated blood lead level of an unclear cause. Among the remaining 21 matched pairs, the risk of hypertension was significantly higher in subjects with plumbism (relative risk, 7.0; 95% confidence interval, 1.2 to 42.3). Mean adjusted creatinine clearance rates for subjects with plumbism, however, were significantly higher than those of controls and supranormal in comparison to rates predicted for sex and age. Subjects with plumbism had significantly lower hemoglobin concentrations and hematocrit readings than the controls. Blood lead and serum creatinine levels were low for both groups. These results suggest that survivors of childhood lead poisoning have an increased risk of clinically significant hypertension developing in the setting of supranormal creatinine clearance rates.