TREATMENT OUTCOMES IN MODERATELY LEAD TOXIC CHILDREN

这项拟议的研究的长期目标是改善 儿童铅吸收增加的影响。为此，我们 将继续评估生物化学和功能后果 儿童体内铅的中等负荷量 临床研究计划的重点是螯合治疗的效果。 我们的多学科方法侧重于身体和身体之间的关系 铅负荷与三种结局。身体铅负荷是 通过三种方式测量：1)血铅浓度，这是近年来的一项指标 2)在CaNa2 EDTA测试中的尿铅排泄，一个指标 活动性铅储存；3)L骨的X射线荧光测定 铅，一种直接、非侵入性和定量的骨铅测量方法，具有 随着时间的推移而积累起来。结果指标是那些受影响的指标 通过铅负担。这些包括：1)生化异常-- 全血红细胞原卟啉(EP)水平及1，25-二苯基-1，5-二苯基-1，2，4，5-二苯基-1，2，4，5-二苯基-1，5-二苯基丙烷 二羟基维生素D(1，25-(OH)2D)和血清骨钙素浓度； 2)中枢神经系统功能障碍，以听觉和 体感诱发电位；3)反映的行为缺陷 通过全球情报衡量，以及具体的 注意力和反应时间。前/后处理设计是允许的 美国描述随着时间的推移治疗对多种结果的影响， 推断中度铅中毒对人体健康的影响 儿童的大脑功能和行为，并通过不同的方法进行探索 铅发挥其毒性作用。

The long-term goal of the proposed research is to ameliorate the harmful effects of increased lead (Pb) absorption in children. To this end, we will continue to assess the biochemical and functional consequences of moderate body burdens of Pb in young children within a comprehensive clinical research program focused on the effects of chelation treatment. Our multidisciplinary approach focuses on the relationships between body burden of Pb and three types of outcomes. Body Pb burden is being measured in three ways: 1) blood Pb concentrations, an index of recent exposure; 2) urinary Pb excretion during CaNa2 EDTA testing, an index of mobilzable Pb stores; and 3) L x-ray fluorescence determination of bone Pb, a direct, non-invasive and quantitative measure of bone Pb that has accumulated over time. The outcome measures are those which are affected by lead burden. these include: 1) biochemical abnormalities -- erythrocyte protoporphyrin levels (EP) in whole blood and 1,25- dihydroxyvitamin D (1,25-(OH)2D) and osteocalcin concentrations in serum; 2) central nervous system dysfunction as indexed by auditory and somatosensory evoked potentials; and 3) behavioral deficits as reflected by global measures of intelligence in addition to specific measures of attention and reaction time. A pre-/post-treatment design is permitting us to describe the effects of treatment on multiple outcomes over time, to make inferences about the effects of moderate Pb toxicity on children's brain function and behavior, and to explore different means by which Pb exerts its toxic effects.