慢性汞中毒的临床分析

目的探讨慢性汞中毒的临床特征。方法以首次驱汞后的尿汞测定值代替自然排泄的尿汞值，对2000年1月-2006年12月住院确诊的10例职业性慢性轻度汞中毒患者（中毒组）进行临床分析，并随机选择住院10例汞吸收者作为吸收组，20例非接触汞的后勤人员作为对照组。结果中毒组驱汞治疗后以及第1—4疗程的尿汞含量显著高于吸收组（P〈0．05），而第5疗程之后的尿汞含量虽高于吸收组，但差异无统计学意义（P〉0．05）。中毒组各种症状发生率与吸收组比较，仅失眠的发生率高于对照组（P〈0．05或P〈0．01），其余症状发生率差异无统计学意义（P〉0．05）。中毒组IgM含量显著低于吸收组和对照组（P〈0．05）。中毒组肌电图有神经性损害1例，蛋白尿1例。结论慢性轻度汞中毒主要临床特征为尿汞含量增高、神经衰弱综合征、口腔疾病和手指震颤。汞中毒的诊断标准中的轻度中毒诊断指标，应列入肌电图神经性损害和蛋白尿的肾损害。

Clinical Analysis of the Chronic Hydrargyrism

[ Objective] To explore the clinical features of chronic hydrargyrism. [ Methods] The spontaneous ejectable urine Hg mensuration value was replaced by the urine Hg mensuration value after the first time of Hg driving; analysis was made on the clinical features of 10 diagnosed cases of light occupational chronic hydrargyrism （toxic group）, 10 eases of randomly chosen Hg absorbers （absorbent group） hospitalized between January 2000 and December 2006 and 20 non-Hg-exposed staff members （control group）. [ Results]The urine Hg mensuration values of the toxic group were significantly higher than that of the absorbent group after Hg driving and the 1st to 4th period of treatment （ P 〈 0.05 ）, but the difference become not significant after the 5th period of treatment （ P 〉 0.05 ） ;the incidence of insomnia in the toxic group was significantly higher than that in the absorbent group and the control （ P 〈 0.05 ）, the difference was not significant in other symptoms （ P 〉 0.05 ） ; the content of IgM in the toxic group was significantly lower than that in the absorbent group and control （ P 〈 0.05 ） ; one case of nerve damage and one case of albuminuria were found in the toxic group. [ Conclusion] The main clinical features of light chronic hydrargyrism were the increase of urine Hg value, neurasthenic syndrome, oral cavity diseases and fingers dindling; nerve damage in the electromyography examination and albuminuria in kidney damage should be added into the diagnosis indexes for light chronic hydrargyrism.