Bradberry Sally M, Sheehan Timothy M T, Barraclough Christopher R, Vale J Allister
West Midlands Poisons Unit, City Hospital, Birmingham, B18 7QH, UK.
Clin Toxicol (Phila). 2009 Nov;47(9):894-8. doi: 10.3109/15563650903333812.
A 36-year-old jewelry producer presented with tremor, slurred speech, lethargy, headache, and incoordination. On examination he had a coarse tremor of the outstretched hands and protruded tongue, slurred speech, "Hatter's shakes" handwriting, impaired heel-toe walking and heel-shin coordination, mild dysdiadochokinesis, and constricted visual fields to confrontation. The patient received four 5-day courses of oral 2,3-dimercapto-1-propanesulfonate (30 mg/kg/day), which was associated with substantial objective clinical improvement and the excretion of 99,406 microg mercury.
We recommend that the administration of 2,3-dimercapto-1-propanesulfonate should be considered in symptomatic patients who have been exposed to mercury vapor and who have supporting analytical confirmation of the diagnosis.
一名36岁的珠宝生产商出现震颤、言语含糊、嗜睡、头痛及共济失调。检查发现，他伸出双手和伸出舌头时有粗大震颤，言语含糊，有“帽匠震颤”样笔迹，足跟-足趾行走及足跟-胫骨协调能力受损，轻度轮替运动障碍，以及对视野检查时视野缩小。该患者接受了四个疗程、为期5天的口服2,3-二巯基-1-丙磺酸钠（30毫克/千克/天）治疗，治疗后临床症状有显著客观改善，且排出汞99,406微克。
对于有汞蒸气暴露史且经分析确诊的有症状患者，我们建议考虑给予2,3-二巯基-1-丙磺酸钠治疗。
