Pollock C A, Ibels L S
Royal North Shore Hospital, Department of Renal Medicine, St. Leonards, N.S.W., Australia.
Aust N Z J Med. 1988 Feb;18(1):46-52. doi: 10.1111/j.1445-5994.1988.tb02239.x.
Thirty-eight Sydney Harbour Bridge workers were assessed for possible lead intoxication. Forty-seven per cent were found to have significant lead intoxication as assessed by calcium disodium edetate chelation (Ca EDTA) testing and were subsequently effectively and safely treated with Ca EDTA. The prevalence of neurological, constitutional, gastrointestinal and musculoskeletal symptoms was significantly greater in those with, than those without, lead toxicity. Although blood lead levels and, to a lesser extent, hematological parameters were of some use in diagnosis, they were not sufficiently sensitive and thus should not be used in screening workers at risk of lead intoxication. Ca EDTA testing remains the diagnostic method of choice. Patients exposed to lead dust and fumes, in whom symptoms of lead intoxication are present, should undergo such testing and if a positive result is obtained, then EDTA chelation therapy should be instituted.
对38名悉尼海港大桥工人进行了铅中毒可能性评估。通过依地酸钙钠螯合试验(Ca EDTA)检测发现,47%的工人有明显的铅中毒,随后用依地酸钙钠进行了有效且安全的治疗。有铅中毒的工人出现神经、体质、胃肠道和肌肉骨骼症状的比例显著高于无铅中毒的工人。尽管血铅水平以及在较小程度上血液学参数在诊断中有一定作用,但它们不够敏感,因此不应将其用于筛查有铅中毒风险的工人。Ca EDTA检测仍是首选的诊断方法。接触铅尘和铅烟且出现铅中毒症状的患者应接受此类检测,如果检测结果为阳性,则应开始进行依地酸钙钠螯合疗法。