中、重度儿童铅中毒Ⅰ值的意义及治疗

Significance of Ⅰ value in children with medium and severe lead poisoning and its treatment

目的分析中、重度儿童铅中毒中每毫克依地酸钙钠的排铅量比值（Ⅰ值）的意义及其治疗,为儿童铅中毒的合理诊断及治疗提供依据。方法对2009年3月~2011年8月我科住院的51例中、重度儿童铅中毒进行回顾性分析,使用火焰原子吸收光谱法（FAAS）测定血铅、尿铅水平,按《儿童高铅血症和铅中毒分级和处理原则（试行）》筛选并治疗,其中中度中毒7例（13.7%）,重度中毒44例（86.3%）,并计算I值。结果中度铅中毒患儿Ⅰ值均小于0.6,重度铅中毒患儿中Ⅰ值大于0.6仅为13.6%（6例）。结论 I值对中、重度儿童铅中毒诊断性驱铅意义不大,应根据儿童铅中毒分级及临床症状驱铅,以免耽误治疗及影响儿童的生长发育。

Objective To provide basis for the reasonable diagnosis and treatment of children with lead poisoning by analyzing the significance of Ⅰ value in children with medium and severe lead poisoning and its treatment.Methods Data of 51 children with medium and severe lead poisoning hospitalized in our department from March 2009 to August 2011 were analyzed retrospectively.The flame atomic absorption spectrometry（FAAS） was used to determine the blood lead and urinary lead levels.Seven children（13.7%） with medium lead poisoning and 44 patients（86.3%） with severe lead poisoning were screened out and treated according to the ＂Grading and Treatment Principles for Children with High Lead Acidosis and Lead Poisoning（Trial）＂ and their Ⅰ values were calculated.Results Ⅰ values of children with medium lead poisoning were all smaller than 0.6 while Ⅰ values of only 13.6%（6 cases） of children with severe lead poisoning were larger than 0.6.Conclusion Ⅰ value is of little significance to diagnostic lead elimination.The diagnostic lead elimination should be carried out according to the grading and clinical symptoms of children with lead poisoning,in order to avoid delay in treatment and harm to children′s growth.