Herrström P, Högstedt B
Primary Care Center Hertig Knut, Halmstad, Sweden.
Scand J Dent Res. 1993 Aug;101(4):232-7. doi: 10.1111/j.1600-0722.1993.tb01111.x.
A total of 142 women and 76 men with self-diagnosed oral galvanism who were referred from dentists and medical doctors for clinical evaluation during the last 2 yr are described from the perspective of general medicine. No case of clinically suspected mercury intoxication was found. Mean concentration of mercury in whole blood (B-Hg) was 17.3 nmol/l, and no value exceeded 50 nmol/l. Amalgam burden and B-Hg were not associated with clinical signs or symptoms except for a significantly lower mean value of B-Hg in patients with psychologic main symptoms than in those without (mean 15.4 vs. 18.1 nmol/l). It was possible to make one or several diagnoses in all 218 cases as reasonable alternatives to the concept of oral galvanism. Mental disorder was the main diagnosis in 93 cases (42.7%), including 41 cases of generalized anxiety disorder and 12 cases of panic disorder. A total of 87 patients (40%) did not work because of medical reasons or unemployment. Amalgam removal was recommended in a total of 65 cases (29%), mainly on psychologic indications, but in 22 cases because of oral conditions. The clinical conditions behind the concept of oral galvanism seem to be explicable in terms of general medicine, and no generalized toxic effect of amalgam fillings need be suspected.
从普通医学的角度描述了过去两年中从牙医和医生处转诊来进行临床评估的142名女性和76名男性，他们自我诊断为口腔电流异常。未发现临床疑似汞中毒病例。全血汞（B-Hg）的平均浓度为17.3 nmol/l，没有值超过50 nmol/l。除了有心理主要症状的患者的B-Hg平均值显著低于无心理主要症状的患者（平均15.4 vs. 18.1 nmol/l）外，汞合金负荷和B-Hg与临床体征或症状无关。在所有218例病例中都有可能做出一种或几种诊断，作为口腔电流异常概念的合理替代。精神障碍是93例（42.7%）的主要诊断，包括41例广泛性焦虑障碍和12例惊恐障碍。共有87名患者（40%）因医疗原因或失业而无法工作。总共65例（29%）建议去除汞合金，主要是基于心理指征，但22例是由于口腔状况。口腔电流异常概念背后的临床情况似乎可以用普通医学来解释，无需怀疑汞合金填充物有普遍的毒性作用。
