Liu Xin, Qiu Ze-wu, Shen Wei, Peng Xiao-bo
Department of Emergency, Chinese PLA Postgraduate Medical School, Beijing 100853,China.
Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2012 Apr;30(4):307-9.
To summarise the clinical features of 18 cases with acute trichloropropane (TCP) poisoning for improving the diagnosis and treatment of the disease.
Exposure history, clinical manifestations, laboratorial examinations, poisoning causes and treatment were retrospectively reviewed in 18 cases with acute TCP poisoning. The results of peripheral lymphocyte micronucleus tests were compared with the healthy control group (n = 33).
The common clinical symptoms were as following: respiratory symptoms were the earlier one set, such as chest tightness in 13, dry and sore throat in 7, cough and runny nose in 2. Gastrointestinal symptoms were more common, such as abdominal pain in 18, nausea and vomit in 14. Only 1 out of 18 patients was found with liver injury. The major manifestation was the increase in ALT and AST, which was returned to normal after treatment. ALL of the 18 patients were found TCP in their serum which concentration was from 39.0 to 310.0 ng/ml, and the average was (68.9 ± 42.1) ng/ml. The symptoms of toxic peripheral neuropathy were typical in all the patients, such as fatigue and numb limb in 18, burning pain of the distal lower limbs in 14, the symmetrical sock-like sensory dysfunction of pain, touch and vibration of the lower limbs in 13, muscle strength reduced in 7, hyporeflexia knee-jerks in 4, hyporeflexia ankle-jerks in 3. The peripheral nerve conduction velocity (NCV) examinations were as followed: the (sensore-nerve conduction velocity) SCV of peroneus super nerve in 18 and the (motor-nerve conduction velocity) MCV of tibial nerve in 8 was slowed down and the distal latency in 18 was prolonged. Micronucleus were found in all 18 cases. The micronucleus rate was 10.06‰ ± 2.80‰ and 8.24‰ ± 2.67‰ in acute TCP poisoning group and healthy control group, respectively. The difference was significant (P < 0.05).
The common clinical manifestations of respiratory exposure of TCP poisoning patients were respiratory symptoms, gastrointestinal symptoms and the symptoms of toxic peripheral neuropathy. Liver injury in those 18 cases was not obvious. Lymphocyte micronucleus of peripheral blood were found in all 18 cases.
总结18例急性三氯丙烷（TCP）中毒患者的临床特征，以提高该病的诊断与治疗水平。
回顾性分析18例急性TCP中毒患者的接触史、临床表现、实验室检查、中毒原因及治疗情况。将外周血淋巴细胞微核试验结果与健康对照组（n = 33）进行比较。
常见临床症状如下：呼吸系统症状出现较早，如胸闷13例、咽干咽痛7例、咳嗽流涕2例。胃肠道症状较为常见，如腹痛18例、恶心呕吐14例。18例患者中仅1例出现肝损伤，主要表现为谷丙转氨酶（ALT）和谷草转氨酶（AST）升高，治疗后恢复正常。18例患者血清中均检测出TCP，浓度为39.0～310.0 ng/ml，平均为（68.9±42.1）ng/ml。所有患者均有典型的中毒性周围神经病症状，如乏力、肢体麻木18例、下肢远端灼痛14例、下肢对称性袜套样痛觉、触觉及振动觉减退13例、肌力减弱7例、膝反射减弱4例、跟腱反射减弱3例。外周神经传导速度（NCV）检查结果如下：18例腓总神经感觉神经传导速度（SCV）及8例胫神经运动神经传导速度（MCV）减慢，18例远端潜伏期延长。18例均发现微核。急性TCP中毒组微核率为10.06‰±2.80‰，健康对照组为8.24‰±2.67‰，差异有统计学意义（P < 0.05）。
TCP中毒经呼吸道接触患者的常见临床表现为呼吸系统症状、胃肠道症状及中毒性周围神经病症状。18例患者肝损伤不明显。18例患者外周血均发现淋巴细胞微核。
