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接种含硫柳汞疫苗的婴儿体内汞的浓度及代谢:一项描述性研究。

Mercury concentrations and metabolism in infants receiving vaccines containing thiomersal: a descriptive study.

作者信息

Pichichero Michael E, Cernichiari Elsa, Lopreiato Joseph, Treanor John

机构信息

Department of Microbiology/Immunology, University of Rochester, Rochester, New York, NY, USA.

出版信息

Lancet. 2002 Nov 30;360(9347):1737-41. doi: 10.1016/S0140-6736(02)11682-5.

Abstract

BACKGROUND

Thiomersal is a preservative containing small amounts of ethylmercury that is used in routine vaccines for infants and children. The effect of vaccines containing thiomersal on concentrations of mercury in infants' blood has not been extensively assessed, and the metabolism of ethylmercury in infants is unknown. We aimed to measure concentrations of mercury in blood, urine, and stools of infants who received such vaccines.

METHODS

40 full-term infants aged 6 months and younger were given vaccines that contained thiomersal (diptheria-tetanus-acellular pertussis vaccine, hepatitis B vaccine, and in some children Haemophilus influenzae type b vaccine). 21 control infants received thiomersal-free vaccines. We obtained samples of blood, urine, and stools 3-28 days after vaccination. Total mercury (organic and inorganic) in the samples was measured by cold vapour atomic absorption.

FINDINGS

Mean mercury doses in infants exposed to thiomersal were 45.6 microg (range 37.5-62.5) for 2-month-olds and 111.3 microg (range 87.5-175.0) for 6-month-olds. Blood mercury in thiomersal-exposed 2-month-olds ranged from less than 3.75 to 20.55 nmol/L (parts per billion); in 6-month-olds all values were lower than 7.50 nmol/L. Only one of 15 blood samples from controls contained quantifiable mercury. Concentrations of mercury were low in urine after vaccination but were high in stools of thiomersal-exposed 2-month-olds (mean 82 ng/g dry weight) and in 6-month-olds (mean 58 ng/g dry weight). Estimated blood half-life of ethylmercury was 7 days (95% CI 4-10 days).

INTERPRETATION

Administration of vaccines containing thiomersal does not seem to raise blood concentrations of mercury above safe values in infants. Ethylmercury seems to be eliminated from blood rapidly via the stools after parenteral administration of thiomersal in vaccines.

摘要

背景

硫柳汞是一种含有少量乙基汞的防腐剂,用于婴幼儿常规疫苗。含硫柳汞疫苗对婴儿血液中汞浓度的影响尚未得到广泛评估,且婴儿体内乙基汞的代谢情况未知。我们旨在测量接种此类疫苗的婴儿血液、尿液和粪便中的汞浓度。

方法

40名6个月及以下的足月婴儿接种了含硫柳汞的疫苗(白喉-破伤风-无细胞百日咳疫苗、乙肝疫苗,部分儿童还接种了b型流感嗜血杆菌疫苗)。21名对照婴儿接种了不含硫柳汞的疫苗。我们在接种疫苗后3 - 28天采集血液、尿液和粪便样本。通过冷蒸气原子吸收法测量样本中的总汞(有机汞和无机汞)。

研究结果

接触硫柳汞的2个月大婴儿平均汞摄入量为45.6微克(范围37.5 - 62.5微克),6个月大婴儿为111.3微克(范围87.5 - 175.0微克)。接触硫柳汞的2个月大婴儿血液汞含量范围为低于3.75至20.55纳摩尔/升(十亿分率);6个月大婴儿的所有数值均低于7.50纳摩尔/升。对照组的15份血液样本中只有1份含有可量化的汞。接种疫苗后尿液中的汞浓度较低,但接触硫柳汞的2个月大婴儿粪便中的汞浓度较高(平均82纳克/克干重),6个月大婴儿粪便中的汞浓度也较高(平均58纳克/克干重)。估计乙基汞在血液中的半衰期为7天(95%可信区间4 - 10天)。

解读

接种含硫柳汞的疫苗似乎不会使婴儿血液中的汞浓度升高至安全值以上。通过疫苗肠胃外给药后,乙基汞似乎能迅速通过粪便从血液中排出。

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