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重金属基础概述

Elementary Overview of Heavy Metals.

作者信息

Jannetto Paul J, Cowl Clayton T

机构信息

Department of Laboratory Medicine & Pathology, Mayo Clinic, Rochester, MN, United States.

Division of Public Health, Infectious Diseases and Occupational Medicine, Mayo Clinic, Rochester, MN, United States.

出版信息

Clin Chem. 2023 Apr 3;69(4):336-349. doi: 10.1093/clinchem/hvad022.

Abstract

BACKGROUND

Exposure to heavy metals is common as a result of environmental contamination of air, water, and soil as well as accumulation in food, tobacco, herbal medicines, and occupational contact. However, clinically relevant toxicity is much less prevalent. Toxic effects, when they occur, may present with non-specific symptoms, resulting in a very large differential for clinicians to consider.

CONTENT

Arsenic, cadmium, lead, and mercury are four heavy metals with no biological role in humans. However, these metals are commonly used in industrial applications and consumer products. Since these elements are not biodegradeable, their potential toxic effects may be long-lasting within the environment. These heavy metals have the potential to accumulate in vital organs such as the brain, heart, and kidney where they may disrupt normal cellular functioning and if exposures are repetitive or of high concentration, toxicity may result.

SUMMARY

The objective of this review is to provide an overview of arsenic, cadmium, lead, and mercury physical properties, common sources of exposure, basic toxicokinetics and health effects, and to review clinical guidelines and treatment strategies. Acute and chronic symptoms and recommended laboratory biomarker testing are also discussed.

摘要

背景

由于空气、水和土壤的环境污染以及在食物、烟草、草药中的累积和职业接触,重金属暴露很常见。然而,具有临床相关性的毒性则不太普遍。当毒性作用发生时,可能会出现非特异性症状,这使得临床医生需要考虑的鉴别诊断范围非常广。

内容

砷、镉、铅和汞是四种对人类没有生物学作用的重金属。然而,这些金属常用于工业应用和消费品中。由于这些元素不可生物降解,它们潜在的毒性作用在环境中可能会长期存在。这些重金属有可能在大脑、心脏和肾脏等重要器官中蓄积,在这些器官中它们可能会扰乱正常的细胞功能,如果反复接触或接触浓度过高,可能会导致中毒。

总结

本综述的目的是概述砷、镉、铅和汞的物理性质、常见暴露源、基本毒物动力学和健康影响,并回顾临床指南和治疗策略。还讨论了急性和慢性症状以及推荐的实验室生物标志物检测。

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