Department of Environmental and Occupational Health, School of Public Health, China Medical University, No. 92 Beier Road, Heping District, Shenyang, Liaoning, Postal code: 110001, PR China.
Environ Toxicol Pharmacol. 2011 Jan;31(1):137-42. doi: 10.1016/j.etap.2010.09.015. Epub 2010 Nov 17.
The aim of this study was to explore therapeutic efficiency of succimer used with calcium and ascorbic acid in the treatment of mildly lead-poisoned mice and preschool children. Mice were exposed to lead by drinking water, and then treated with saline solution, 50mg/kg body weight (b.w.) succimer, 100mg/kg b.w. succimer, or 50mg/kg b.w. succimer plus calcium and ascorbic acid by gavage. Seventy-two children aged 48-72 months were randomly assigned into combined treatment or nutritional intervention group. Lead levels in blood and bone were analyzed by atomic absorption spectrophotometry. Activities of aminolevulinic acid dehydratase (ALAD) in blood were determined by colorimetric method. Results of animal experiment showed that succimer used alone could reduce lead levels in blood and bone and reverse activities of ALAD in blood, however, a better therapeutic efficiency in mobilizing bone lead could be achieved by succimer used with calcium and ascorbic acid. Findings from the clinical study showed that reduction of blood lead levels (BLLs) between the end and initiation of therapy in the combined treatment group was significantly greater than that in the nutritional intervention group. Percentage of children with BLLs less than 10μg/dL at the end of therapy and the eighth week after therapy in the combined treatment group was significantly higher than that in the nutritional intervention group. In conclusion, combined use of succimer with calcium and ascorbic acid seemed to be a choice in the treatment of mildly lead poisoned children.
本研究旨在探讨依地酸钙钠联合钙和抗坏血酸在治疗轻度铅中毒小鼠和学龄前儿童中的疗效。通过饮用含铅水使小鼠染铅,然后分别用生理盐水、50mg/kg 体重(b.w.)依地酸钙钠、100mg/kg b.w.依地酸钙钠和 50mg/kg b.w.依地酸钙钠加钙和抗坏血酸灌胃进行治疗。72 名 48-72 月龄的儿童被随机分为联合治疗组或营养干预组。采用原子吸收分光光度法检测血和骨中的铅含量,比色法检测血中氨基酮戊酸脱水酶(ALAD)的活性。动物实验结果表明,依地酸钙钠单独使用可降低血和骨中的铅含量,逆转血中 ALAD 的活性,但依地酸钙钠加钙和抗坏血酸联合使用可更好地动员骨中的铅。临床研究结果表明,联合治疗组治疗结束时和治疗开始时的血铅水平(BLLs)较营养干预组降低更为显著,治疗结束和治疗后第 8 周时联合治疗组血铅水平<10μg/dL 的儿童比例显著高于营养干预组。综上所述,依地酸钙钠联合钙和抗坏血酸似乎是治疗轻度铅中毒儿童的一种选择。