Ouyang G L, Wang L H, Xie G S, Zhu H B
Department of Neurology, The First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, China.
Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi. 2022 Apr 20;40(4):276-279. doi: 10.3760/cma.j.cn121094-20210111-00012.
Objective to investigate the health changes of patients with severe trimethyltin chloride (TMT) poisoning in four years. Six patients with severe TMT poisoning treated in the First Affiliated Hospital of Gannan Medical College in August 2016 were numbered 1, 2, 3, 4, 5 and 6 respectively. The patients were followed up 0.5, 2 and 4 years after poisoning and compared and analyzed. The follow-up contents include: symptom degree, score of simple mental intelligence examination scale (MMSE) and modified Rankin Scale (MRS) , cranial magnetic resonance imaging (MRI) , EEG, etc. The symptoms of dizziness, headache, chest tightness, palpitation, nausea and vomiting decreased gradually in 6 patients. The symptoms of speech disorder and memory decline in No.1, 2 and 3 patients gradually increased, and the scores of MMSE and Mrs gradually decreased; Patients No.4, 5 and 6 had improved speech disorder, but their memory decreased, MMSE and Mrs scores were still flat, and mild cognitive impairment. The brain atrophy of No.1, 2 and 3 patients was aggravated, which showed obvious atrophy of hippocampus, temporal lobe, insular lobe and cerebellum and enlargement of ventricle; There was no significant change in brain atrophy in No.4, 5 and 6 patients. The neurotoxic symptoms in the later stage of severe TMT poisoning are still serious, and the neurotoxic time is long.
目的 探讨重度三甲基氯化锡（TMT）中毒患者4年的健康变化情况。选取2016年8月在赣南医学院第一附属医院治疗的6例重度TMT中毒患者，分别编号为1、2、3、4、5、6。于中毒后0.5年、2年及4年进行随访并对比分析。随访内容包括：症状程度、简易精神智能检查表（MMSE）评分及改良Rankin量表（MRS）评分、头颅磁共振成像（MRI）、脑电图（EEG）等。6例患者头晕、头痛、胸闷、心悸、恶心、呕吐等症状逐渐减轻。1、2、3号患者言语障碍、记忆力减退症状逐渐加重，MMSE及MRS评分逐渐降低；4、5、6号患者言语障碍有所改善，但记忆力下降，MMSE及MRS评分仍持平，存在轻度认知功能障碍。1、2、3号患者脑萎缩加重，表现为海马、颞叶、岛叶及小脑明显萎缩，脑室扩大；4、5、6号患者脑萎缩无明显变化。重度TMT中毒后期神经毒性症状仍严重，且神经毒性时间长。
