依地酸钙钠治疗儿童慢性中度铅中毒方案研究

Research in Ca Na2EDTA in the treatment of chronic moderate lead poisoning in children

目的研究依地酸钙钠(Ca Na2EDTA)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Ca Na2EDTA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。Ca Na2EDTA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 Ca Na2EDTA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。

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 of14patients with chronic moderate lead poisoning treated with CaNa2EDTA for3consecutive courses of lead removal during September2014to December2016were analyzed retrospectively.Twenty-four hour urinary lead levels during hospitalization were analyzed.The changes of blood lead levels before treatment,3days,and5days after treatment were also analyzed.Results In the14children(4males and10females)average age was2.35±1.47years.After treatment with CaNa2EDTA for3consecutive courses,the blood lead levels were decreased significantly in all the patients,and the blood lead levels at3days after treatment were0.76,0.77,0.72times those at5days after treatment respectively.The decrease of blood lead levels per unit of drug in the first3days of treatment were significantly higher than those in5days of treatment(P<0.05).The decrease of blood lead levels at3days after treatment was0.65,0.71,0.70times,those in5days’treatment respectively.The decrease of urine lead levels per unit of drug in the first3days of treatment were significantly higher than those in5days of treatment(P<0.05).Conclusions CaNa2EDTA has an obvious effect on removal of lead.The efficiency of lead removal in3days of treatment was higher than in5days of treatment.Thus,a course of treatment for3days may be an altenative for a course of5days.