University of Brasilia, Brasilia, DF, Brazil.
Trop Med Int Health. 2009 Dec;14(12):1515-22. doi: 10.1111/j.1365-3156.2009.02408.x.
To evaluate the levels of antimony in plasma and skin of patients being treated with pentavalent antimonials (Glucantime) and their relationship with side effects.
We evaluated 19 patients treated endovenously at the conventional dose (20 mg Sb(v)/kg/day), two at a smaller dose (5 mg Sb(v)/kg/day) and three treated intralesionally (up to 4.0 ml/week). During treatment, patients underwent periodic blood exams and were interviewed weekly about the incidence of adverse symptoms. The levels of antimony in plasma and skin samples were determined by Inductively Coupled Plasma with Mass Spectrometry (ICP-MS).
The patients under conventional treatment presented a mean initial antimony plasma concentration of 3.39 microg/l; at the end of treatment, these levels were 0.21 before Glucantime application and 125.8 mg after Glucantime application. The mean antimony level in their skin at the end of the treatment was 9.24 microg/g. The main adverse symptoms were arthralgia and myalgia; laboratory results showed mainly lymphocytosis and eosinophilia.
We found some significant correlations between antimony concentrations, adverse symptoms and laboratory alterations, strengthening the hypothesis of a dose-dependent relationship between antimony concentration in plasma and skin and side effects.
评估接受五价锑（葡萄糖酸锑钠）治疗的患者的血浆和皮肤中的锑水平及其与副作用的关系。
我们评估了 19 名接受静脉内常规剂量（20mg Sb（v）/kg/天）治疗的患者，2 名接受较小剂量（5mg Sb（v）/kg/天）治疗的患者，3 名接受皮损内治疗的患者（每周最多 4.0ml）。在治疗过程中，患者定期进行血液检查，并每周询问不良反应的发生情况。通过电感耦合等离子体质谱法（ICP-MS）测定血浆和皮肤样本中的锑水平。
接受常规治疗的患者初始血浆锑浓度平均为 3.39μg/l；治疗结束时，应用葡萄糖酸锑钠前为 0.21μg/l，应用后为 125.8mg/l。治疗结束时，皮肤中的锑平均水平为 9.24μg/g。主要不良反应为关节痛和肌痛；实验室结果主要表现为淋巴细胞增多和嗜酸性粒细胞增多。
我们发现锑浓度、不良反应和实验室改变之间存在一些显著相关性，这加强了血浆和皮肤中锑浓度与副作用之间存在剂量依赖性关系的假设。
