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尿β2-微球蛋白不能作为水俣病的诊断工具。

Urinary beta-2-microglobulin does not serve as diagnostic tool for Minamata disease.

作者信息

Ohi G, Yamamoto S, Inaba Y, Fujino T, Itai Y, Ueno K, Nakajima K, Saito H, Shiroishi K

出版信息

Arch Environ Health. 1982 Nov-Dec;37(6):336-41. doi: 10.1080/00039896.1982.10667587.

Abstract

"Minamata disease" (methylmercury poisoning), originally found in Minamata, Japan 3 decades ago, still poses a medico-socio-legal problem mostly resulting from difficulty in drawing diagnostic demarcation. To examine the efficacy of urinary beta-2-microglobulin (BMG) in identifying patients with Minamata disease, the authors studied 115 patients (63 males and 52 females) who were officially registered for compensation (registered patients); 114 patients (54 males, 60 females) currently undergoing medical evaluations for compensation (unregistered patients); and 82 control subjects (40 males, 42 females) matched for sex and age. There was no significant difference with regard to urinary BMG (corrected by creatinine) among the above three groups, although there was a parallel increase in urinary BMG and neurological scores of male patients which suggested the presence of a dose-effect relationship. Although renal tubular dysfunction manifesting hyper-beta-2-microglobulinuria has been reported in patients with Minamata disease, our findings indicate that excessive excretion of BMG is not a satisfactory diagnostic parameter for Minamata disease.

摘要

“水俣病”(甲基汞中毒)30年前最初在日本水俣被发现,如今仍是一个医学、社会和法律问题,主要原因是难以划定诊断界限。为了检验尿β2微球蛋白(BMG)在识别水俣病患者方面的功效,作者研究了115名正式登记以获取赔偿的患者(登记患者,63名男性和52名女性);114名目前正在接受赔偿医学评估的患者(未登记患者,54名男性,60名女性);以及82名年龄和性别匹配的对照对象(40名男性,42名女性)。上述三组之间尿BMG(经肌酐校正)无显著差异,尽管男性患者的尿BMG和神经学评分呈平行增加,提示存在剂量效应关系。虽然有报道称水俣病患者存在表现为高β2微球蛋白尿的肾小管功能障碍,但我们的研究结果表明,BMG排泄过多并非水俣病令人满意的诊断参数。

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