Berger O G, Gregg D J, Succop P A
Division of Ambulatory and Community Pediatrics, Children's Hospital Medical Center, Cincinnati, Ohio 45229.
J Pediatr. 1990 Jan;116(1):46-51. doi: 10.1016/s0022-3476(05)81643-9.
To determine whether unstimulated urine samples could be used to identify children needing chelation therapy for lead poisoning, we compared urinary lead excretion with and without chelation. A convenience sample of 39 children was admitted to a pediatric clinical research center for therapeutic chelation. Urine was collected for 24 hours on 2 consecutive days. Edetate disodium calcium, 1000 mg/m2, was given intramuscularly in two divided doses on the second day. Significant correlations existed between urinary lead excretion (PbU) on the control day at 12- and 24-hour collection intervals and on the first day of chelation (p less than 0.0001). Published criteria for positive edetate disodium calcium provocative tests were used to calculate corresponding cutoff points for unstimulated 24-hour PbU. Resultant PbU values ranged from 10.4 to 35.6 micrograms (0.05 to 0.17 mumol). When PbU was expressed in terms of creatinine excretion, cutoff points of 0.06 and 0.19 microgram PbU/mg creatinine were determined, making possible the use of random unstimulated samples to assist in the identification of children in need of chelation.
为了确定未受刺激的尿液样本是否可用于识别需要进行螯合疗法治疗铅中毒的儿童，我们比较了进行螯合治疗前后的尿铅排泄情况。选取了39名儿童作为便利样本，他们被收治到一家儿科临床研究中心接受治疗性螯合治疗。连续两天收集24小时尿液。在第二天，以1000 mg/m²的剂量分两次肌肉注射依地酸二钠钙。对照日12小时和24小时收集间隔时的尿铅排泄量（PbU）与螯合治疗第一天的尿铅排泄量之间存在显著相关性（p<0.0001）。采用已发表的依地酸二钠钙激发试验阳性标准来计算未受刺激的24小时尿铅排泄量的相应截断点。最终的尿铅排泄量值范围为10.4至35.6微克（0.05至0.17微摩尔）。当以肌酐排泄量来表示尿铅排泄量时，确定了截断点为0.06和0.19微克尿铅/毫克肌酐，这使得利用随机未受刺激的样本协助识别需要进行螯合治疗的儿童成为可能。
