Bearer C F, O'Riordan M A, Powers R
Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio, USA.
J Pediatr. 2000 Oct;137(4):549-54. doi: 10.1067/mpd.2000.108273.
The objective of this study was to determine the exposure of premature infants to lead from blood transfusions.
Blood lead concentrations were determined for 19 very premature infants at the time of admission, at 4 weeks of life, and before and after transfusions and in the donor packed red blood cells of 79 transfusions.
The number of transfusions per patient was 4. 2 +/- 2.8 (mean +/- SD) with 15.7 +/- 1.9 mL/kg packed red blood cells for a lead dose of 1.56 +/- 1.77 microg/dL. The total dose of lead from these transfusions over the 4-week period was 4.0 +/- 2.8 microg/kg (range, 0.9-10.6 microg/kg). Increases in post-transfusion blood lead concentration were linear with doses higher than 1.5 microg/dL. Packed red blood cells with a blood lead concentration of > or = 5 microg/dL resulted in an elevated post-transfusion blood lead concentration in some infants.
The lead exposure to these infants through blood transfusion exceeds the acceptable daily intake values for lead and may result in unacceptably high post-transfusion blood lead concentrations. Use of packed red blood cells with lead concentrations <3.3 microg/dL is one cost-effective means to reduce exposure.
本研究的目的是确定早产儿因输血而接触铅的情况。
测定了19名极早产儿入院时、出生4周时、输血前后以及79次输血的献血者浓缩红细胞中的血铅浓度。
每位患者的输血次数为4.2±2.8（平均值±标准差），输入浓缩红细胞的量为15.7±1.9毫升/千克，铅剂量为1.56±1.77微克/分升。在4周时间内，这些输血所导致的铅总剂量为4.0±2.8微克/千克（范围为0.9 - 10.6微克/千克）。输血后血铅浓度的升高与高于1.5微克/分升的剂量呈线性关系。血铅浓度≥5微克/分升的浓缩红细胞在一些婴儿中导致输血后血铅浓度升高。
这些婴儿通过输血接触铅的量超过了铅的可接受每日摄入量值，可能导致输血后血铅浓度高得不可接受。使用铅浓度＜3.3微克/分升的浓缩红细胞是减少接触的一种经济有效的方法。
