驱铅治疗患者尿中总锌含量的分析

目的研究驱铅治疗患者尿中总锌的含量及变化，为对症治疗提供科学依据。方法选择2012年1月—2013年4月进行驱铅治疗的35名患者作为研究对象，采集其24h空白尿及不同治疗阶段的试排尿进行尿铅和尿锌含量的分析。结果比较24h空白尿，男女尿铅含量差异无统计学意义（P〉0．05），男性尿锌含量高于女性，差异有统计学意义（P〈0．01）。轻度铅中毒的患者与铅吸收观察对象的空白尿锌含量间差异无统计学意义（P〉0．05）。尿锌含量与年龄不存在相关关系（P〉0．05），与尿铅含量存在不密切的正相关（r=0．429，P〈0．05）；第1疗程第1、第2、第3针后的尿锌含量显著高于空白尿，差异有统计学意义（P〈0．01）；第1、第2针排出的尿铅与尿锌不存在相关性（P〉0．05），而第3针后两者存在显著的正相关关系（r=0．667，P〈0．01）。空白尿锌与试排各个阶段的尿锌间均不存在相关关系（P〉0．05）。结论使用依地酸二钠钙进行驱铅治疗的患者尿中排出大量的锌，疗程后期尿锌会随铅排出的增加而增加，所以在治疗的过程中，尤其是在疗程后期要特别注意微量元素丢失出现的不良反应，及时对症治疗。

Analysis of the total zinc content in urine of patients with chelation therapy

[ Objective] To study the total zinc contents and changes in urine of patients with chelation therapy, provide scientific ev- idence for the symptomatic treatment. [ Methods ] 35 patients who have received the chelation therapy from January 2012 to April 2013 were selected. The 24-hour blank urine samples and urine samples at different treatment stages were collected to analyze the total zinc and lead contents. [Results] There was no significant difference in zinc content of 24-hour blank urine samples between males and females （ P 〉 0.05 } , and the urinary zinc content in males was significantly higher than that in females （ P 〈 0.01 ）. No significant difference was found between patients with mild lead poisoning and people with lead absorption in blank urine zinc con- tent { P 〉 0.05 ）. There was no correlation between urinary zinc content and age （ P 〉 0.05 }, and the urinary zinc content was not closely correlated with the urinary lead content （ r = 0.429,P 〈 0.05 ）. The urinary zinc contents after the first, second and third dose of the first course were significantly higher than the blank urine zinc content （ P 〈 0.01 ）. There was no correlation between u- rinary zinc content and the urinary lead contents after the first and second dose { P 〉 0.05 }, while there was a significant positive correlation between urinary zinc content and the urinary lead contents after the third dose （ r = 0.667, P 〈 0.01 }. There was no cor- relation between blank urine zinc content and the urine zinc content at different treatment stages {P 〉 0.05）. [ Conclusion] Large amounts of zinc will be excreted with the lead in urine during the chelation therapy of calcium disodium edentate, especially in the late course of the therapy. Therefore, it is necessary to pay great attention to the adverse reaction of trace elements missing in chela- tion therapy, and take the symptomatic treatment promptly.