Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning, China.
Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases, Guangxi Medical University, Nanning, China.
Toxicol Ind Health. 2024 Jan-Feb;40(1-2):41-51. doi: 10.1177/07482337231215411. Epub 2023 Nov 20.
Lead is one of the heavy metals that is toxic and widely distributed in the environment, and children are more sensitive to the toxic effects of lead because the blood-brain barrier and immune system are not yet well developed. The objective of the study was to investigate the clinical characteristics of lead poisoning in children aged 0∼6 years in a hospital in Guangxi, and to provide scientific basis for the prevention and treatment of lead poisoning. We collected and analyzed the clinical data of 32 children with lead poisoning admitted to a hospital in Guangxi from 2010 to 2018. The results showed that most of the 32 cases presented with hyperactivity, irritability, poor appetite, abdominal pain, diarrhea, or constipation. The hemoglobin (HGB), mean corpusular volume (MCV), mean corpuscular hemoglobin (MCH), and hematocrit (HCT) of the lead-poisoned children were all decreased to different degrees and were below normal acceptable levels. Urinary β-microglobulin was increased. Blood lead levels (BLL) decreased significantly after intravenous injection of the lead chelator, calcium disodium edetate (CaNa-EDTA). In addition, HGB returned to normal levels, while MCV, MCH, and HCT increased but remained below normal levels. Urinary β-microglobulin was reduced to normal levels. Therefore, in this cohort of children, the high-risk factors for lead poisoning are mainly Chinese medicines, such as baby powder. In conclusion, lead poisoning caused neurological damage and behavioral changes in children and decreased erythrocyte parameters, leading to digestive symptoms and renal impairment, which can be attenuated by CaNa-EDTA treatment.
铅是一种重金属，具有毒性，广泛分布于环境中，儿童对铅的毒性作用更为敏感，因为血脑屏障和免疫系统尚未发育完善。本研究旨在探讨广西某医院 0∼6 岁儿童铅中毒的临床特征，为铅中毒的防治提供科学依据。我们收集并分析了 2010 年至 2018 年期间广西某医院收治的 32 例铅中毒患儿的临床资料。结果显示，32 例患儿中多数表现为多动、易激惹、食欲不振、腹痛、腹泻或便秘。铅中毒患儿的血红蛋白（HGB）、平均红细胞体积（MCV）、平均红细胞血红蛋白（MCH）和血细胞比容（HCT）均不同程度降低，均低于正常可接受水平。尿β-微球蛋白升高。静脉注射铅螯合剂依地酸二钠钙（CaNa-EDTA）后，血铅水平（BLL）显著下降。此外，HGB 恢复正常水平，而 MCV、MCH 和 HCT 增加但仍低于正常水平。尿β-微球蛋白降至正常水平。因此，在本队列儿童中，铅中毒的高危因素主要是中药，如婴儿爽身粉。总之，铅中毒可导致儿童神经损伤和行为改变，降低红细胞参数，引起消化症状和肾功能损害，CaNa-EDTA 治疗可减轻这些损害。
