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[有机汞化合物所致脑病]

[Encephalopathy due to organomercuric compounds].

作者信息

Lefèvre J P, Gil R

出版信息

Sem Hop. 1977 Jan 16;53(3):165-71.

PMID:189429
Abstract

A 27 year old agricultural worker presented about one month after treating cereal seeds with an alcoxyalkyl mercurial derivative, an encephalopathy with a confusional state, a cerebellar stato-kinetic syndrome, an intention tremor and grand mal epileptic fits. Treatment with dimercaprol produced a clinical improvement on the fourth day with a fall in blood mercury from 3.5 mug to 2.2 mug whilst urinary excretion of mercury remained low. A fortnight later the patient was completely cured. Although less common than collective poisoning by ingestion, organo-mercurial encephalopathies due to occupational exposure are a real danger although it is not known whether the relative rareness of published cases is due only to lack of observance of security rules or to individual sensitivity which might be due to increased absorption of mercury through the lungs or skin. This case shows that although alkyl mercurial derivatives are reputed to be the most dangerous, alcoxyalkyl derivatives may also cause encephalopathies. Also, as long as non-toxic substances remain unavailable for use in agriculture, one should emphasise the necessity of careful observance of the security rules during manipulation of these products.

摘要

一名27岁的农业工人在使用一种烷氧基烷基汞衍生物处理谷物种子约一个月后,出现了一种脑病,伴有意识模糊状态、小脑运动失调综合征、意向性震颤和癫痫大发作。用二巯丙醇治疗后,第四天临床症状有所改善,血汞从3.5微克降至2.2微克,而尿汞排泄量仍然很低。两周后,患者完全治愈。尽管职业性接触有机汞导致的脑病比经口集体中毒少见,但却是一种现实的危险,尽管尚不清楚已发表病例相对较少是仅由于未遵守安全规则,还是由于个体敏感性,这可能是由于汞通过肺或皮肤的吸收增加所致。该病例表明,尽管烷基汞衍生物被认为是最危险的,但烷氧基烷基衍生物也可能导致脑病。此外,只要农业中仍没有无毒物质可供使用,就应强调在处理这些产品时严格遵守安全规则的必要性。

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