亚急性砷中毒452例的临床表现与尿砷值关系的探讨

目的探讨452例亚急性砷中毒患者临床表现与尿砷值的关系。方法对砷污染饮用水致亚急性砷中毒452例的临床表现、诊断和实验室检查结果进行分析。结果饮用水的砷含量分别为3．19mg／L和3．26Ing／L，分别超标318倍和325倍；452例初检尿砷值为0．24～11．2mg／L（1．41±1．52）mg／L]；中毒患者出现消化系统、心血管系统和神经系统的症状分别为389、249和359例；心肌酶、肝功能、肾功能、血常规和尿常规异常分别为237、98、76、91和140例；心电图异常106例。全组452例均诊断为亚急性砷中毒，其中轻、中、重度中毒分别为370、74和8例；中毒患者尿砷含量与受损的器官数及诊断分级呈正相关关系，具有统计学意义（r=0．552，r=0．678，P均〈0．01）。结论尿砷值可作为亚急性砷中毒诊断及分级的重要指标。

Relationship between the clinical manifestations and the urine arsenic value in 452 cases of the subacute arsenic intoxication

Objective To analyze the relationship between the clinical manifestations and the urine arsenic value in 452 cases of subacute arsenic intoxication. Methods The clinical manifestations, the diagnosis and the laboratory check result in 452 cases of subacute arsenic intoxication led by the tap wate of arsenic pollution were analyzed. Results Tile arsenic content of tap water was 3. 19 mg/L and 3.26 mg/L, exceeded 318 times and 325 times of the allowed figures. The urine arsenic value initially examined in 452 cases were 0. 24 - 11.2 mg/L （ 1.41 ± 1.52 mg/L）. In the 452 patients, 389,249 and 359 eases presented the symptoms of digesting system, the cardiovascular system and nervous system respectively, and 237, 98, 76, 91, 140 and 106 cases presented anomalies of cardiac muscle enzyme, the liver function, the kidney function, the routine blood test, the routine urine test, and electrocardiogram respectively. The numbers of patients diagnosed as the light, moderate, and severe poisoning were 370, 74 and 8 cases respectively. In these patients, the urine arsenie content was positively correlated with the injured organ number and the diagnosis gradation（r = 0. 552,r = 0. 678,P 〈 0. 01 ,respectively）. Conclusion On the basis of analysed results, the urine arsenic content is a important indicator for diagnosis of the subacute arsenic intoxication and grades.