临床儿科杂志 ›› 2017, Vol. 35 ›› Issue (9): 673-.doi: 10.3969/j.issn.1000-3606.2017.09.010

• 综合报道 • 上一篇    下一篇

依地酸钙钠治疗儿童慢性中度铅中毒方案研究

应晓兰, 郜振彦, 马文娟, 吴美琴, 徐健, 颜崇淮   

  1. 上海交通大学医学院附属新华医院 教育部和上海市环境与儿童健康重点实验室(上海 200092)
  • 收稿日期:2017-09-15 出版日期:2017-09-15 发布日期:2017-09-15
  • 通讯作者: 颜崇淮 E-mail:yanch@shkeylab-ceh.org
  • 基金资助:
    科技部九七三课题(No.2012CB525001)

Research in CaNa2EDTA in the treatment of chronic moderate lead poisoning in children

YING Xiaolan, GAO Zhenyan, MA Wenjuan, WU Meiqin, XU Jian, YAN Chonghuai   

  1. MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiaotong University, School of Medicine, Shanghai 200092, China
  • Received:2017-09-15 Online:2017-09-15 Published:2017-09-15

摘要: 目的 研究依地酸钙钠(CaNa2EDTA)治疗慢性中度铅中毒疗效,以优化儿童铅中毒的螯合治疗方案。方 法 回顾分析2014年9月—2016年12月接受CaNa2EDTA连续3个疗程驱铅治疗的14例慢性中度铅中毒患儿的临床资料, 分析住院期间每日24小时尿铅水平,以及治疗前、治疗3天和5天后血铅水平的变化。结果 14例患儿中,男4例、女10例, 平均年龄(2.35±1.47)岁。CaNa2EDTA治疗后血铅均显著下降。三疗程治疗3天的血铅下降值分别为治疗5天下降值 的0.76、0.77、0.72。三疗程3天单位用药血铅下降值高于5天单位用药血铅下降值,差异均有统计学意义(P<0.05)。 三 疗程治疗3天的尿铅下降值分别为治疗5天下降值的0.65、0.71、0.70。三疗程3天单位用药尿铅排出量高于5天单位用 药尿铅排出量,差异均有统计学意义(P<0.05)。 结论 CaNa2EDTA驱铅疗效明显, 3天驱铅效率高于5天,治疗3天为 一疗程的方案或许可作为原5天一疗程的替补方案。

Abstract:  Objectives To explore the efficacy of CaNa2EDTA in the treatment of chronic moderate lead poisoning, so as to optimize the chelation therapy for lead poisoning in children. Methods The clinical data of 14 patients with chronic moderate lead poisoning treated with CaNa2EDTA for 3 consecutive courses of lead removal during September 2014 to December 2016 were analyzed retrospectively. Twenty-four hour urinary lead levels during hospitalization were analyzed. The changes of blood lead levels before treatment, 3 days, and 5 days after treatment were also analyzed. Results In the 14 children (4 males and 10 females) average age was 2.35±1.47 years. After treatment with CaNa2EDTA for 3 consecutive courses, the blood lead levels were decreased significantly in all the patients, and the blood lead levels at 3 days after treatment were 0.76, 0.77, 0.72 times those at 5 days after treatment respectively. The decrease of blood lead levels per unit of drug in the first 3 days of treatment were significantly higher than those in 5 days of treatment (P<0.05). The decrease of blood lead levels at 3 days after treatment was 0.65, 0.71, 0.70 times , those in 5 days’ treatment respectively. The decrease of urine lead levels per unit of drug in the first 3 days of treatment were significantly higher than those in 5 days of treatment (P<0.05). Conclusions CaNa2EDTA has an obvious effect on removal of lead.The efficiency of lead removal in 3 days of treatment was higher than in 5 days of treatment. Thus, a course of treatment for 3 days may be an altenative for a course of 5 days.