Björkman L, Sandborgh-Englund G, Ekstrand J
Department of Basic Oral Sciences, Karolinska Institutet, Stockholm, Sweden.
Toxicol Appl Pharmacol. 1997 May;144(1):156-62. doi: 10.1006/taap.1997.8128.
The toxicological consequences of exposure to mercury (Hg) from dental amalgam fillings is a matter of debate in several countries. The purpose of this study was to obtain data on Hg concentrations in saliva and feces before and after removal of dental amalgam fillings. In addition Hg concentrations in urine, blood, and plasma were determined. Ten subjects had all amalgam fillings removed at one dental session. Before removal, the median Hg concentration in feces was more than 10 times higher than in samples from an amalgam free reference group consisting of 10 individuals (2.7 vs 0.23 mumol Hg/kg dry weight, p < 0.001). A considerable increase of the Hg concentration in feces 2 days after amalgam removal (median 280 mumol Hg/kg dry weight) was followed by a significant decrease. Sixty days after removal the median Hg concentration was still slightly higher than in samples from the reference group. In plasma, the median Hg concentration was 4 nmol/liter at baseline. Two days after removal the median Hg concentration in plasma was increased to 5 nmol/liter and declined subsequently to 1.3 nmol/liter by Day 60. In saliva, there was an exponential decline in the Hg concentration during the first 2 weeks after amalgam removal (t 1/2 = 1.8 days). It was concluded that amalgam fillings are a significant source of Hg in saliva and feces. Hg levels in all media decrease considerably after amalgam removal. The uptake of amalgam mercury in the GI tract in conjunction with removal of amalgam fillings seems to be low.
牙科汞合金填充物中汞（Hg）暴露的毒理学后果在几个国家都是一个有争议的问题。本研究的目的是获取去除牙科汞合金填充物前后唾液和粪便中汞浓度的数据。此外，还测定了尿液、血液和血浆中的汞浓度。10名受试者在一次牙科治疗中全部去除了汞合金填充物。去除之前，粪便中汞浓度的中位数比由10名个体组成的无汞合金对照组样本中的汞浓度中位数高出10倍以上（2.7 vs 0.23 μmol Hg/kg干重，p < 0.001）。汞合金去除后2天，粪便中汞浓度大幅增加（中位数为280 μmol Hg/kg干重），随后显著下降。去除后60天，汞浓度中位数仍略高于对照组样本中的浓度。血浆中汞浓度在基线时为4 nmol/升。去除后2天，血浆中汞浓度中位数增加到5 nmol/升，随后在第60天降至1.3 nmol/升。在唾液中，汞合金去除后的前2周内汞浓度呈指数下降（半衰期 = 1.8天）。研究得出结论，汞合金填充物是唾液和粪便中汞的重要来源。去除汞合金填充物后，所有介质中的汞水平都大幅下降。与去除汞合金填充物相关的胃肠道对汞合金汞的吸收似乎较低。
