The use of chelating agents in occupational lead poisoning
The use of chelating agents in occupational lead poisoning
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DOI：
10.1093/occmed/46.1.41
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发表时间：
1996-02-01
影响因子：
5.1
通讯作者：
Alessio, L
中科院分区：
文献类型：
--
作者：
Porru, S;Alessio, L
长期以来，螯合剂一直被用于铅中毒的药物治疗，其管理仍然是一个问题，特别是在发展中国家。本文综述了二硫丙醇、青霉胺、二硫代二乙二胺四乙酸钙和二硫代己琥珀酸的药理特性，分析了它们的适应证、禁忌证和副作用，并讨论了每种药物在职业性铅中毒中的可能用途。还提出了对有中毒体征和症状的受试者以及低-中度铅吸收受试者的治疗和随访建议。CaNa2EDTA似乎是目前可用的最可靠、最安全的螯合剂，而且作用范围更广。DMSA在职业性铅中毒的治疗中前景看好。尽管毫无疑问，螯合疗法显著降低了职业性铅中毒的死亡率和发病率，但这种疗法在有轻微神经或肾脏损害的受试者中的疗效尚未得到适当的研究。
Chelating agents have long been used in the pharmacological treatment of lead poisoning, whose management is still a problem, particularly in developing countries. This article reviews the pharmacological properties of dimercaprole, penicillamine, CaNa2EDTA and dimercaprosuccinic acid, examines their indications, contraindications and side effects and discusses the possible use of each drug in occupational Pb poisoning. Proposals are also presented for the treatment and follow-up of subjects with signs and symptoms of poisoning and of subjects with low-moderate Pb absorption. CaNa2EDTA seems to be the most reliable and safer chelating agent nowadays available and with a wider spectrum of action. DMSA seems to be promising in the treatment of occupational Pb poisoning. Even though there is no doubt that chelation therapy has significantly contributed to reduce mortality and morbidity from occupational Pb poisoning, the efficacy of this treatment in subjects with subtle neurological or renal damage has not yet been studied properly.