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接种含硫柳汞疫苗后新生儿和婴儿体内的汞含量。

Mercury levels in newborns and infants after receipt of thimerosal-containing vaccines.

作者信息

Pichichero Michael E, Gentile Angela, Giglio Norberto, Umido Veronica, Clarkson Thomas, Cernichiari Elsa, Zareba Grazyna, Gotelli Carlos, Gotelli Mariano, Yan Lihan, Treanor John

机构信息

Department of Microbiology/Immunology, Pediatrics, and Medicine, University of Rochester, Rochester, New York 14642, USA.

出版信息

Pediatrics. 2008 Feb;121(2):e208-14. doi: 10.1542/peds.2006-3363.

Abstract

OBJECTIVES

Thimerosal is a mercurial preservative that was widely used in multidose vaccine vials in the United States and Europe until 2001 and continues to be used in many countries throughout the world. We conducted a pharmacokinetic study to assess blood levels and elimination of ethyl mercury after vaccination of infants with thimerosal-containing vaccines.

METHODS

Blood, stool, and urine samples were obtained before vaccination and 12 hours to 30 days after vaccination from 216 healthy children: 72 newborns (group 1), 72 infants aged 2 months (group 2), and 72 infants aged 6 months (group 3). Total mercury levels were measured by atomic absorption. Blood mercury pharmacokinetics were calculated by pooling the data on the group and were based on a 1-compartment first-order pharmacokinetics model.

RESULTS

For groups 1, 2, and 3, respectively, (1) mean +/- SD weights were 3.4 +/- 0.4, 5.1 +/- 0.6, and 7.7 +/- 1.1 kg; (2) maximal mean +/- SD blood mercury levels were 5.0 +/- 1.3, 3.6 +/- 1.5, and 2.8 +/- 0.9 ng/mL occurring at 0.5 to 1 day after vaccination; (3) maximal mean +/- SD stool mercury levels were 19.1 +/- 11.8, 37.0 +/- 27.4, and 44.3 +/- 23.9 ng/g occurring on day 5 after vaccination for all groups; and (4) urine mercury levels were mostly nondetectable. The blood mercury half-life was calculated to be 3.7 days and returned to prevaccination levels by day 30.

CONCLUSIONS

The blood half-life of intramuscular ethyl mercury from thimerosal in vaccines in infants is substantially shorter than that of oral methyl mercury in adults. Increased mercury levels were detected in stools after vaccination, suggesting that the gastrointestinal tract is involved in ethyl mercury elimination. Because of the differing pharmacokinetics of ethyl and methyl mercury, exposure guidelines based on oral methyl mercury in adults may not be accurate for risk assessments in children who receive thimerosal-containing vaccines.

摘要

目的

硫柳汞是一种汞类防腐剂,在美国和欧洲,直到2001年它一直被广泛用于多剂量疫苗瓶中,并且在世界上许多国家仍在使用。我们进行了一项药代动力学研究,以评估接种含硫柳汞疫苗的婴儿体内乙基汞的血药浓度和消除情况。

方法

从216名健康儿童中采集接种疫苗前以及接种后12小时至30天的血液、粪便和尿液样本,这些儿童分为三组:72名新生儿(第1组)、72名2个月大的婴儿(第2组)和72名6个月大的婴儿(第3组)。通过原子吸收法测量总汞水平。通过汇总各组数据计算血液汞药代动力学,并基于一室一级药代动力学模型。

结果

对于第1、2和3组,分别有:(1)平均±标准差体重为3.4±0.4、5.1±0.6和7.7±1.1千克;(2)最大平均±标准差血液汞水平分别为5.0±1.3、3.6±1.5和2.8±0.9纳克/毫升,在接种疫苗后0.5至1天出现;(3)所有组在接种疫苗后第5天的最大平均±标准差粪便汞水平分别为19.1±11.8、37.0±27.4和44.3±23.9纳克/克;(4)尿液汞水平大多检测不到。计算出血液汞半衰期为3.7天,并在第30天恢复到接种前水平。

结论

婴儿疫苗中硫柳汞的肌肉注射乙基汞的血液半衰期明显短于成人口服甲基汞的半衰期。接种疫苗后粪便中汞水平升高,表明胃肠道参与了乙基汞消除。由于乙基汞和甲基汞的药代动力学不同,基于成人口服甲基汞的暴露指南可能不适用于对接种含硫柳汞疫苗儿童的风险评估。

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