| Objective: Recurrent respiratory tract infections(RRTI)have a serious impact on children’s growth and development and physical and mental health.The relevant research mainly focuses on congenital anatomical factors,low immune function,lack of mineral elements,pathogenic microbial infections and environmental factors.In recent years,studies have reported that elevated blood lead levels in children can suppress immune function and may be associated with respiratory infections in children,but there are few reports on related studies.Therefore,this study provides a reference for understanding the level of lead exposure in children with RRTI and other influencing factors,further exploring the causes of RRTI,and taking targeted preventive measures to reduce the level of lead exposure in children and the occurrence and development of RRTI.Methods: Using a case-control method,from December 2017 to December 2019,hospitalized children with RRTI of 3 to 6 years old were collected in a ward of a tertiary hospital in Shenyang,and non-RRTI children were matched according to age and gender as the control group.With the informed consent of the parents,take the method of voluntary participation,collect fasting venous blood,and test blood lead,blood iron(Fe),zinc(Zn),calcium(Ca),copper(Cu),magnesium(Mg),IgG,IgA,IgM level,and conduct a questionnaire survey on parents.After all the survey data were verified,the SPSS22.0software was used for data entry and data analysis.Results:1.A total of 137 children in the case group were collected in this survey,including64 boys(46.7%)and 73 girls(53.3%),with an average age of 4.09±1.04 years.There were138 children in the control group,including 67 boys(48.6%)and 71 girls(51.4%),with an average age of 4.22±1.07 years.There was no significant difference between the two groups of children in age,gender,height,weight and BMI(all P>0.05).2.The average blood lead content of children in the case group was 28.84±12.48μg/L,and the detection rate of excess was 7.3%.The average blood lead content of children in the control group was 23.94±10.65μg/L,and the detection rate of excess was 2.9%.The blood lead content of children in the case group was significantly higher than that in the control group(t=3.502,P<0.05),but there was no statistical difference in the detection rate of lead exceeding the standard between the two groups(P>0.05).3.The single factor analysis results of children’s RRTI showed that: influencing factors related to RRTI include whether the home has been decorated in the past year,whether it has pets,father’s smoking,mothers suffering from chronic diseases during pregnancy,children’s premature birth,the habit of washing hands before meals,partial eclipse,IgA level,IgG level,blood zinc content,blood iron content and blood lead level(all P<0.05);And the IgA and IgG levels was negatively correlated with blood lead level(all P<0.05).4.Multivariate Logistic analysis showed: Chronic diseases during pregnancy are an independent risk factor for children’s RRTI(OR=5.023,95%CI: 1.084-23.273),and higher IgG levels are protective factors for children from RRTI(OR=0.360,95%CI: 0.255-0.507),(all P<0.05).5.Interaction analysis results showed: There is an interaction between father’s smoking and renovation in the past year(OR=18.660,95%CI:1.555-223.961);there is an interaction between hand washing before meals and blood lead levels(OR=1.029,95%CI:1.004-1.055);there is an interaction between children’s partial eclipse and blood lead levels(OR=1.126,95%CI:1.052-1.206);there is an interaction between children’s premature delivery and blood lead levels(OR=1.3331,95%CI:1.017-1.743),(all P<0.05);the interaction of the above two factors showed a risk factor effect,and the interaction between a higher IgG level and a low blood lead level showed a protective factor effect(OR=0.974,95% CI:0.963-0.985),(all P<0.05).Conclusion: 1.The lead exposure levels of children with RRTI in a hospital in Shenyang were significantly higher than those in the control group,and the detection rates of excessive blood lead is 7.3% in children with RRTI,the detection rates of excessive blood lead in the control group is 2.9%.2.Chronic diseases during pregnancy is an independent risk factor for children’s RRTI.Children’s high IgG level is a protective factor for RRTI,and IgG level is negatively correlated with blood lead levels.3.Father’s smoking and decoration in the past year,blood lead and many influencing factors like hand washing before meals can interact with each other to increase the risk of RRTI in children.4.The level of lead exposure of hospitalized children with RRTI in Shenyang is generally low,and higher levels of lead exposure may indirectly affect the occurrence and development of RRTI by reducing IgG levels. |
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