摘要目的:探讨中国华东某城市儿童的血清中多环芳烃加合物与血清补体C3、C4水平的剂量-效应关系。方法:于2016年9月，以华东地区某市大气污染暴露区和对照区（在大气污染暴露区的上风向30 km以外的区域）的2所寄宿制学校为研究现场，招募符合标准的学龄儿童。共纳入273名学生，暴露组和对照组分别有163、110名。收集研究期间两个地区的全年空气污染物数据（PM 2.5、PM 10和NO 2），利用尿中可替宁评估烟草暴露水平，全自动生化分析仪测定血清补体C3、C4水平，ELISA法测定血清反式二氢二醇环氧苯并［a］芘（BPDE）-白蛋白加合物水平，并采用线性回归模型探讨BPDE-白蛋白加合物和血清补体C3、C4的剂量-效应关系。 结果:273名儿童的年龄为（13.67±0.37）岁，其中男生165名（60.4%）。暴露组儿童的PM 2.5、PM 10和NO 2年均暴露水平以及血清BPDE-白蛋白加合物水平高于对照组（ P<0.05）。线性回归模型分析结果显示，调整年龄、性别、BMI z-评分和尿可替宁水平后，儿童血清BPDE-白蛋白加合物水平每升高10%，儿童血清补体C4水平下降1.20%（ P=0.017）；调整年龄、BMI z-评分和尿可替宁水平后，男生血清BPDE-白蛋白加合物水平每升高10%，血清补体C4水平降低1.68%（ P = 0.024）；调整年龄、性别和BMI z-评分后，尿可替宁检出组的儿童血清BPDE-白蛋白加合物水平每升高10%，血清补体C3、C4水平分别降低1.31%和3.57%（ P<0.05）。 结论:儿童血清多环芳烃加合物与补体C4有明显的剂量-效应关系。

abstractsObjective:To investigate the dose-response relationship between serum polycyclic aromatic hydrocarbon adducts and serum complement C3 and C4 levels among children from a city in East China.Methods:In September 2016, two boarding schools in the air pollution exposure area and the control area (beyond the upwind of 30 km in the air pollution exposure area) in a city in East China were selected as the research site, and the eligible school-age children were recruited as the research objects. A total of 273 children were included, including 163 in the exposure group and 110 in the control group. The annual air pollutant data (PM 2.5, PM 10 and NO 2) of the two regions during the study period were collected. The exposure level of tobacco was evaluated by cotinine in urine. The levels of serum complement C3 and C4 were determined by automatic biochemical analyzer. The serum anti-7, 8, -dihydrodiol-9, 10-epoxide benzo[a]pyrene (BPDE)-albumin adduct levels were detected by ELISA. Linear regression model was used to explore the dose-response relationship between BPDE-albumin adducts and serum complement C3 and C4. Results:The age of 273 subjects was (13.67±0.37) years old, including 165 boys (60.4%). The average annual exposure levels of PM 2.5, PM 10 and NO 2 and the level of serum BPDE-albumin adducts in the exposure group were higher than those in the control group ( P<0.05). The results of linear regression model analysis showed that after adjusting age, sex, BMI z-score and urinary cotinine level, when the serum BPDE-albumin adduct level increased by 10%, the serum complement C4 level decreased by 1.2% ( P=0.017). After adjusting age, BMI z-score and urinary cotinine level, for every 10% increase in serum BPDE-albumin adduct level in boys, the serum complement C4 level decreased by 1.68% ( P=0.024). After adjusting age, sex and BMI z-score, the levels of serum complement C3 and C4 decreased by 1.31% and 3.57% respectively for every 10% increase in serum BPDE-albumin adducts among children in the urinary cotinine detection group ( P<0.05). Conclusion:There is a significant dose-response relationship between serum BPDE-albumin adducts and the complement C4 among children.