Amitai Y, Brown M J, Graef J W, Cosgrove E
Division of Clinical Pharmacology and Toxicology, Children's Hospital Medical Center, Boston, MA.
Pediatrics. 1991 Nov;88(5):893-7.
Acute elevations of venous blood lead levels (PbB) are periodically reported in children with chronic lead poisoning, during deleading of their houses. To evaluate this phenomenon 114 preschool children who entered the Massachusetts Childhood Lead Poisoning Prevention Program case management system during 1984 and 1985 were retrospectively studied. PbB increased from a mean (+/- SE) of 1.76 +/- 0.03 mumol/L (36.4 +/- 0.6 micrograms/dL) prior to deleading to 2.03 +/- 0.07 mumol/L (42.1 +/- 1.5 micrograms/dL) during deleading (P less than .001). Among 41 subjects for whom deleading was done by dry scraping and sanding, the mean mid-deleading PbB was higher than the pre-deleading PbB by 0.44 +/- 0.12 mumol/L (9.1 +/- 2.4 micrograms/dL). However, when deleading was done by covering or replacement of painted surfaces in the residences of 12 subjects, mid-deleading PbB decreased 0.11 +/- 0.12 mumol/L (2.25 +/- 2.4 micrograms/dL) (P less than .005). In a subset of 59 subjects who had no chelation therapy and were available for follow-up 250 +/- 14 days after completion of deleading, PbB had decreased from 1.72 +/- 0.04 mumol/L (35.7 +/- 0.9 micrograms/dL) to 1.24 +/- 0.04 mumol/L (25.5 +/- 0.9 micrograms/dL) (P less than .001). The long-term effect of deleading is a significant reduction in PbB. However, deleading resulted in a significant, albeit transient, increase in PbB.
在对房屋进行除铅处理期间，患有慢性铅中毒的儿童中会定期报告静脉血铅水平（PbB）的急性升高。为评估这一现象，对1984年和1985年进入马萨诸塞州儿童铅中毒预防计划病例管理系统的114名学龄前儿童进行了回顾性研究。除铅处理前，PbB平均（±标准误）为1.76±0.03μmol/L（36.4±0.6μg/dL），除铅处理期间升至2.03±0.07μmol/L（42.1±1.5μg/dL）（P＜0.001）。在41名通过干法刮擦和打磨进行除铅处理的受试者中，除铅处理中期的平均PbB比除铅处理前高0.44±0.12μmol/L（9.1±2.4μg/dL）。然而，对12名受试者住所中的涂漆表面进行覆盖或更换来进行除铅处理时，除铅处理中期的PbB降低了0.11±0.12μmol/L（2.25±2.4μg/dL）（P＜0.005）。在59名未接受螯合疗法且在除铅处理完成后250±14天可进行随访的受试者子集中，PbB已从1.72±0.04μmol/L（35.7±0.9μg/dL）降至1.24±0.04μmol/L（25.5±0.9μg/dL）（P＜0.001）。除铅处理的长期效果是PbB显著降低。然而，除铅处理导致PbB显著升高，尽管是短暂的。
