降低慢性中毒女性胎儿铅暴露的安全策略。
A safe strategy to decrease fetal lead exposure in a woman with chronic intoxication.
作者信息
Leiba Adi, Hu Howard, Zheng Amin, Kales Stefanos N
机构信息
Department of Internal Medicine, Mount Auburn Hospital, Harvard Medical School, Cambridge, Massachusetts, USA.
出版信息
J Matern Fetal Neonatal Med. 2010 Aug;23(8):932-4. doi: 10.3109/14767050903317708.
During pregnancy skeletal lead is mobilized by maternal bone turnover and can threaten fetal development. The exact strategy suggested to women of childbearing age, who were chronically exposed to lead, and, thus, have high bone lead burden, is not well established. We describe 4 years of follow-up of a 29-year-old woman with chronic lead intoxication. We (a) advised her to delay conception until 'toxicological clearance', (b) treated her with multiple courses of lead chelator, DMSA, and (c) prescribed oral calcium. Patient had low blood lead and protoporphyrin level during pregnancy until delivery. Delaying conception, lead chelation, and calcium supplementation can decrease fetal exposure.
孕期，母体骨转换会动员骨骼中的铅，这可能会威胁胎儿发育。对于长期接触铅、骨铅负荷高的育龄女性，目前尚未明确具体的应对策略。我们报告了一名29岁慢性铅中毒女性的4年随访情况。我们（a）建议她推迟受孕，直至实现“毒理学清除”；（b）用多疗程的铅螯合剂二巯丁二酸（DMSA）对她进行治疗；（c）开具口服钙剂。该患者孕期直至分娩时血铅和原卟啉水平均较低。推迟受孕、进行铅螯合治疗以及补充钙剂可减少胎儿铅暴露。
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