Frisch Melissa, Schwartz Brian S
Division of Occupational and Environmental Health, Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland 21205, USA.
Environ Health Perspect. 2002 Apr;110(4):433-6. doi: 10.1289/ehp.02110433.
Hair analysis is used to assess exposure to heavy metals in patients presenting with nonspecific symptoms and is a commonly used procedure in patients referred to our clinic. We are frequently called on to evaluate patients who have health-related concerns as a result of hair analysis. Three patients first presented to outside physicians with nonspecific, multisystemic symptoms. A panel of analytes was measured in hair, and one or more values were interpreted as elevated. As a result of the hair analysis and other unconventional diagnostic tests, the patients presented to us believing they suffered from metal toxicity. In this paper we review the clinical efficacy of this procedure within the context of a patient population with somatic disorders and no clear risk factors for metal intoxication. We also review limitations of hair analysis in this setting; these limitations include patient factors such as low pretest probability of disease and test factors such as the lack of validation of analytic techniques, the inability to discern between exogenous contaminants and endogenous toxicants in hair, the variability of analytic procedures, low interlaboratory reliability, and the increased likelihood of false positive test results in the measurement of panels of analytes.
头发分析用于评估出现非特异性症状患者的重金属暴露情况，是转至我们诊所的患者常用的一项检查。我们经常被要求评估那些因头发分析而对健康状况有所担忧的患者。三名患者最初因非特异性多系统症状就诊于外部医生。对头发中的一组分析物进行了检测，其中一项或多项指标被解读为升高。由于头发分析及其他非常规诊断检查，这些患者前来我们这里就诊，认为自己患有金属中毒。在本文中，我们在患有躯体疾病且无明确金属中毒风险因素的患者群体背景下，回顾了该检查的临床疗效。我们还回顾了在此情况下头发分析的局限性；这些局限性包括患者因素，如疾病的预检概率低，以及检查因素，如分析技术缺乏验证、无法区分头发中的外源性污染物和内源性毒物、分析程序的变异性、实验室间可靠性低，以及在分析物检测中出现假阳性结果的可能性增加。
