Liu Xiao-ling, Wang Han-bin, Sun Cheng-wen, Xiong Xi-shan, Chen Zhi, Li Zhao-sheng, Han Bo, Yang Gang
Department of Nephrology, Affiliated Hospital of the Academy of Military Medical Sciences, Poison Control Center of PLA, Beijing 100071, China.
Zhonghua Nei Ke Za Zhi. 2011 Aug;50(8):687-9.
To summarize the clinical features of mercury poisoning diagnosed by blood and urine tests for improving the diagnosis and treatment of the disease.
Poisoning causes, clinical manifestations, diagnosis, treatment and prognosis were retrospectively reviewed in 92 in-patients with mercury poisoning in our hospital from January 2000 to April 2010.
Of the 92 patients, 37 were male and 55 were female with an average age of 33.1 (2 - 65) years old. The mercury poisoning was caused by occupational exposure and non-occupational exposure, such as iatrogenic exposure, life exposure and wrong intake or suicidal intake of mercury-containing substances, mainly through respiratory tract, digestive tract and skin absorption. The most common clinical symptoms were as the followings: nervous system symptom, such as memory loss in 50 cases (54.3%), fatigue in 34 (37.0%), numb limb in 25 (27.2%), dizziness and headache in 22 (23.9%), cacesthesia in 20 (21.7%), fine tremor (finger tip, tongue tip, eyelids) in 15 (16.3%), insomnia and more dreams in 12 (13.0%); gastrointestinal symptoms: nausea in 16 (17.4%), abdominal pain in 14 (15.2%), stomatitis in 5 (5.4%); joint and muscle symptoms: muscle pain in 16 (17.4%), joint pain in 5 (5.4%); cardiovascular system: chest tightness, heart palpitations in 6 (6.5%); urinary system: edema in 9 (9.8%); other system: hidrosis in 20 (21.7%). After the treatment with sodium dimercaptopropane sulfonate (DMPS), the symptoms were gradually alleviated. Their gastrointestinal, cardiovascular symptoms were alleviated within 2 weeks; neurological symptoms were alleviated within 3 months; kidney damage showed a slower recovery and could be completely alleviated within 6 months.
Because of its diverse clinical symptoms, the mercury poisoning was easy to misdiagnosis and missed diagnosis; therefore the awareness of the disease should be further enhanced. Leaving from the poisoning environment timely and giving appropriate treatment with DMPS will lead to a satisfactory prognosis.
总结通过血液和尿液检测诊断出的汞中毒的临床特征，以提高该病的诊断和治疗水平。
回顾性分析2000年1月至2010年4月我院收治的92例汞中毒住院患者的中毒原因、临床表现、诊断、治疗及预后情况。
92例患者中，男性37例，女性55例，平均年龄33.1（2 - 65）岁。汞中毒由职业暴露和非职业暴露引起，如医源性暴露、生活暴露以及误服或自杀性摄入含汞物质，主要通过呼吸道、消化道和皮肤吸收。最常见的临床症状如下：神经系统症状，如记忆力减退50例（54.3%）、乏力34例（37.0%）、肢体麻木25例（27.2%）、头晕头痛22例（23.9%）、感觉异常20例（21.7%）、细微震颤（指尖、舌尖、眼睑）15例（16.3%）、失眠多梦12例（13.0%）；胃肠道症状：恶心16例（17.4%）、腹痛14例（15.2%）、口腔炎5例（5.4%）；关节和肌肉症状：肌肉疼痛16例（17.4%）、关节疼痛5例（5.4%）；心血管系统：胸闷、心悸6例（6.5%）；泌尿系统：水肿9例（9.8%）；其他系统：多汗20例（21.7%）。经二巯丙磺酸钠（DMPS）治疗后，症状逐渐缓解。其胃肠道、心血管系统症状在2周内缓解；神经系统症状在3个月内缓解；肾脏损害恢复较慢，6个月内可完全缓解。
由于汞中毒临床症状多样，易误诊和漏诊；因此应进一步提高对该病的认识。及时脱离中毒环境并给予DMPS适当治疗，预后良好。
