Bensefa-Colas L, Andujar P, Descatha A
Service de pathologie professionnelle, groupe hospitalier Cochin-Saint-Vincent-de-Paul, AP-HP, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France.
Rev Med Interne. 2011 Jul;32(7):416-24. doi: 10.1016/j.revmed.2009.08.024. Epub 2010 Jun 25.
Mercury is a widespread heavy metal with potential severe impacts on human health. Exposure conditions to mercury and profile of toxicity among humans depend on the chemical forms of the mercury: elemental or metallic mercury, inorganic or organic mercury compounds. This article aims to reviewing and synthesizing the main knowledge of the mercury toxicity and its organic compounds that clinicians should know. Acute inhalation of metallic or inorganic mercury vapours mainly induces pulmonary diseases, whereas chronic inhalation rather induces neurological or renal disorders (encephalopathy and interstitial or glomerular nephritis). Methylmercury poisonings from intoxicated food occurred among some populations resulting in neurological disorders and developmental troubles for children exposed in utero. Treatment using chelating agents is recommended in case of symptomatic acute mercury intoxication; sometimes it improves the clinical effects of chronic mercury poisoning. Although it is currently rare to encounter situations of severe intoxication, efforts remain necessary to decrease the mercury concentration in the environment and to reduce risk on human health due to low level exposure (dental amalgam, fish contamination by organic mercury compounds…). In case of occupational exposure to mercury and its compounds, some disorders could be compensated in France. Clinicians should work with toxicologists for the diagnosis and treatment of mercury intoxication.
汞是一种广泛存在的重金属,对人类健康可能产生严重影响。人类接触汞的情况及其毒性特征取决于汞的化学形态:元素汞或金属汞、无机汞化合物或有机汞化合物。本文旨在回顾和综合临床医生应了解的汞毒性及其有机化合物的主要知识。急性吸入金属汞或无机汞蒸气主要会引发肺部疾病,而慢性吸入则更容易引发神经或肾脏疾病(脑病以及间质性或肾小球性肾炎)。某些人群因食用受污染食物而发生甲基汞中毒,导致子宫内接触甲基汞的儿童出现神经紊乱和发育问题。对于有症状的急性汞中毒,建议使用螯合剂进行治疗;有时这能改善慢性汞中毒的临床症状。尽管目前严重中毒的情况很少见,但仍有必要努力降低环境中的汞浓度,并减少因低水平接触(牙科汞合金、有机汞化合物对鱼类的污染……)对人类健康造成的风险。在法国,如果是职业性接触汞及其化合物,某些疾病可以得到补偿。临床医生应与毒理学家合作进行汞中毒的诊断和治疗。