Zhou B, Liu S P, Zhou J S, Song Y G
Hefei Third Clinical College of Anhui Medical University (The Third People＇s Hospital of Hefei) , Hefei 230022, China.
Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China.
Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2021 Apr 20;39(4):289-292. doi: 10.3760/cma.j.cn121094-20200326-00156.
To analyse the clinical characteristics of mercury-toxic nephrotic syndrome and to find the risk factors. A total of 126 patients with mercury-toxic admitted to Beijing Chaoyang Hospital from January 2017 to January 2020 were selected as the research objectives. General data such as age, gender, mercury exposure history of all patients and laboratory data such as urine mercury and urine creatinine were collected. The clinical manifestations and pathological types of patients with mercury-toxic nephrotic syndrome were analyzed, and the risk factors of mercury-toxic nephrotic syndrome were found by univariate and multivariate logistic regression analysis. Among the 24 patients with mercury-toxic nephrotic syndrome, 1 was poisoned by respiratory tract, 6 were poisoned by digestive tract, and 17 were poisoned by skin absorption. In addition to the manifestations of kidney injury, some of the patients also showed neurological symptoms such as dizziness, fatigue, hand tremor, and limb pain. The main pathological types were membranous nephropathy (9 cases) and micropathological nephropathy (10 cases) . The results of multivariate logistic regression analysis showed that the digestive tract and skin absorption pathways of mercury were risk factors for mercury-toxic nephrotic syndrome (=21.099, 23.840, <0.05) . The absorption pathway of mercury has an important influence on the pathogenesis of mercury-toxic nephrotic syndrome, especially in patients with mercury poisoning absorbed by the skin and digestive tract, the risk of complicating nephrotic syndrome is higher.
分析汞中毒肾病综合征的临床特征并寻找危险因素。选取2017年1月至2020年1月在北京朝阳医院收治的126例汞中毒患者作为研究对象。收集所有患者的年龄、性别、汞接触史等一般资料以及尿汞、尿肌酐等实验室数据。分析汞中毒肾病综合征患者的临床表现及病理类型，通过单因素和多因素logistic回归分析找出汞中毒肾病综合征的危险因素。在24例汞中毒肾病综合征患者中，1例经呼吸道中毒，6例经消化道中毒，17例经皮肤吸收中毒。部分患者除有肾损伤表现外，还出现头晕、乏力、手抖、肢体疼痛等神经症状。主要病理类型为膜性肾病（9例）和微小病变肾病（10例）。多因素logistic回归分析结果显示，汞的消化道和皮肤吸收途径是汞中毒肾病综合征的危险因素（=21.099，23.840，<0.05）。汞的吸收途径对汞中毒肾病综合征的发病机制有重要影响，尤其是经皮肤和消化道吸收汞中毒的患者，并发肾病综合征的风险更高。
