补充钙剂治疗儿童铅中毒效果的系统评价

摘要

Objective To evaluate the effectiveness and safety of calcium supplement in treating childhood lead poisoning.Methods MEDLINE, EMBASE, the Cochrane Library, CBM, and CNKI up to May 2009 were searched, relevant journals and article reference lists were also hand-searched.Calcium supplement to mild and moderate lead poisoning in children, ranged from 0 to 14 years old, randomized controlled trials reported in English or Chinese were included.Results Of 633 possibly relevant articles that we identified, 4 studies involving 306 children met the inclusion criteria.The analysis showed that when calcium supplement reached the recommended dietary allowance ( RDA ), a greater reduction in children's blood lead concentrations than placebo group ( WMD 42.22, 95％ CI 23.06 to 61.37), but there was no significant difference between excessive calcium supplement group and the placebo group ( MD 8, 95％ CI -26.58 to 42.58).However, either sufficient calcium supplement or excessive calcium supplement ( ≤ 1 800 mg/d ) was safe for children with lead poisoning.Conclusions Calcium supplement could reduce blood lead level in a calcium-deficient and lead-poisoned children, but it is uncertain in reducing children's blood lead levels for those lead-poisoned children with dietary calcium sufficiency.%目的 系统评价补充钙剂治疗儿童铅中毒的疗效与安全性.方法 检索相关文献数据库,并手工检索相关领域其他杂志.纳人以轻、中度铅中毒,年龄0～14岁儿童为研究对象,比较补充钙剂与其他疗法的疗效的随机对照试验,评价纳入研究的文献质量,并用RevMan5.0软件进行meta分析.结果 共检索到633篇文献,最终筛选出4篇研究,共306例患儿.分析结果显示:当补充钙剂达到每日需要量时,补充钙剂组比对照组血铅降低值比较差异有统计学意义,其WMD及95%CI为:42.22(23.06～61.37);过量补充钙剂与钙剂充足的安慰剂对照组血铅下降无统计学意义,其MD及95%CI为:8(26.58～42.58).结论 足量补充钙剂能显著降低缺钙铅中毒儿童的血铅,如儿童钙剂摄入充足,过量补充钙剂能否降低儿童血铅尚证据不足.