抗生素的人体健康风险、内暴露特征及检测技术研究进展  

Research progress on human health risk,internal exposure characteristics and analysis technologies of antibiotics

作　　者：李振环 朱英[1] 胡小键[1] 谢琳娜 LI Zhenhuan;ZHU Ying;HU Xiaojian;XIE Linna(China CDC Key Laboratory of Environment and Population Health,National Institute of Environmental Health,Chinese Center for Disease Control and Prevention,Beijing,100021,China)

机构地区：[1]中国疾病预防控制中心环境与人群健康重点实验室,中国疾病预防控制中心环境与健康相关产品安全所,北京100021

出　　处：《环境化学》2023年第12期4051-4066,共16页Environmental Chemistry

基　　金：中央财政经费项目(131031108000150003);国家自然科学基金(22106155);环境化学与生态毒理学国家重点实验室开放基金(KF2018-20)资助。

摘　　要：抗生素自问世以来,被广泛应用于临床治疗、畜牧业、农业和水产养殖业等领域中,在治疗感染性疾病和促进生长方面功不可没.但是,抗生素的大量使用甚至滥用,使得环境外暴露和人体内暴露水平升高,进而对生态环境和人体健康造成严重威胁.本文对抗生素的使用现状进行概述,并系统综述了尿液、血清、母乳、唾液等介质中抗生素的检测方法、内暴露特征及人体健康风险的研究进展.目前液相色谱串联质谱法是抗生素最常用的分析方法,固相萃取法是人体生物样本抗生素分析中最常用的前处理方法.人体抗生素内暴露靶向分析中,已有报道涵盖抗生素类别最多的分析方法包括41种抗生素及2种代谢物,而疑似靶向和非靶向分析方法鲜有报道,此后需进一步优化抗生素的提取和分析方法,开发涵盖更多抗生素及其代谢物类型的前处理技术及靶向、疑似靶向和非靶向分析方法.已有流行病学研究多是基于问卷调查、处方药记录和抗生素的产量和使用量调查等开展,而基于抗生素的实际负荷水平的人体健康风险研究和流行病学研究仍然有限,因此亟待开展涵盖不同地区、不同人群的抗生素内暴露特征和队列研究.Since the appearance of antibiotics,they have been widely used in clinical therapeutics,animal husbandry,agriculture,aquaculture,and other fields,especially in treating of infectious diseases and promoting growth.However,the extensive use or even abuse of antibiotics increases the levels of external exposure and internal exposure,which poses a serious threat to the ecological environment and human health.In this review,the current usage situation of antibiotics had been summarized,and the detection methods in human matrix(urine,serum,breast milk,saliva),internal exposure characteristics and human health risks of antibiotics,had been systematically reviewed.At present,liquid chromatography-tandem mass spectrometry(LC-MS/MS)is the most commonly used determination method for antibiotics,and solid phase extraction(SPE)is the most common pretreatment method of antibiotics in human biological samples.In targeted analysis of antibiotics in human biological matrix,the reported method covering the most types of antibiotics included 41 antibiotics and 2 metabolites.However,there are few reports on methods of suspected targeted and non-targeted analysis of antibiotics.Therefore,it is necessary to further optimize the extraction and analysis methods of antibiotics,and develop targeted,suspected targeted and non-targeted analysis methods that covering more types of antibiotics and their corresponding metabolites in the future.Most of the existing epidemiological studies are based on questionnaires,prescription drug records,antibiotic production and usage surveys,but human health risk studies and epidemiological studies based on the actual levels of antibiotics internal exposure are still limited.Therefore,it is urgent to carry out studies on internal exposure characteristics and of antibiotics in different regions and populations.

关 键 词：抗生素 人体健康风险 内暴露水平 耐药性 检测技术. 

分 类 号：R978.1[医药卫生—药品] X503.1[医药卫生—药学]