儿童铅暴露临床资料分析及疗效观察  

Effect of treatment and clinical data analysis of children lead exposure

作　　者：李时莲[1] 张美和[1] 宋文琪[1] 焦宏[1] 

机构地区：[1]首都医科大学附属北京儿童医院,100045

出　　处：《中国妇幼保健》2008年第16期2233-2235,共3页Maternal and Child Health Care of China

摘　　要：目的:观察铅暴露儿童主要症状、年龄特点、环境铅来源及锌钙制剂治疗前后血铅水平变化。方法:对2003年～2004年首都医科大学附属北京儿童医院就诊的43名铅暴露儿童诊治资料进行分析。铅暴露诊断参考指标为血铅大于5μg/dL,同时伴有症状者。资料分析包括:主要症状、血铅水平、环境铅源、年龄性别特点等。同时,对驱铅治疗前后血铅与血矿物元素等的变化进行评估。结果:血铅值在5～10μg/dl伴有临床症状的患儿占30.2%(13/43),男女儿童均在8～9岁时就诊率最高。膨化食品、玩具、碳酸饮料、房屋装修和咬铅笔是导致儿童铅暴露的高危因素,注意力涣散、易激惹和多动为最常见症状。用葡萄糖酸钙锌口服溶液躯铅治疗后,血铅值显示有意义下降(P<0.001),同时可防止血矿物元素的下滑。结论:神经症状出现在血铅水平<10μg/dl,说明铅损害可以发生在目前的诊断标准以下。铅损害的主要症状表现在神经系统。锌钙合剂治疗对降低血铅和恢复血钙、锌水平有较好效果。Objective： To examine the association of main symptoms, relation with age, source of lead and the response of blood - lead levels with treatment of calcium and zinc in lead poison children. Methods： 43 children patients with lead exposure from this hospital during 2003 ～ 2004 year were diagnosed and treated. The blood lead value ≥5 μg/dl with overt signs or symptoms of lead toxicity were defined undue lead exposure. The data of symptoms, blood - lead level, environmental lead exposure, gender and age were analyzed. The blood - lead level and the blood - mineral element level were also estimated before and after treatment. Results： Among them 30. 2% （ 13/ 43） cases showed symptoms of lead poison at blood -lead level 5 ～ 10 μg/dl. Most of cases were diagnosed at 8 ～ 9 years. Extruding food, battery toys, carbonate - contained drink, lead - based paint, and pencils using were high risk factors to expose lead. Attention deficit disorder, irritability, and hyperactive behavior were most common symptoms. Treatment with calcium and zinc gluconates oral solution showed that the blood lead - level significantly come down （ P 〈 0. 001 ） and the blood - mineral dement level was prevented from declination. Conclusion： Low blood - lead level children with symptoms of lead toxicity that suggests it may cause poisoning with blood - lead level blow 10 μg/dl. The main symptoms of lead toxicity are from nerve system. Treatment with calcium and zinc oral solution is effi- cient to lowering blood - lead and remaining blood - mineral element level

关 键 词：儿童铅暴露 血铅 葡萄糖酸钙锌口服溶液 

分 类 号：R174[医药卫生—妇幼卫生保健]