含轻粉中药丸导致急性汞中毒

1例46岁男性患者,因下肢皮肤湿疹服用某诊所自制中药丸（每粒约含21mg轻粉）1粒,2次/d,共服用13粒。第7天患者出现头晕、胸闷、口腔溃疡伴发热、周身疼痛,且症状逐渐加重遂入院。查体：T37.2℃,面部及躯干部皮肤可见充血性红斑,压之褪色;口腔黏膜充血,齿龈红肿。实验室检查：血汞0.029mg/L,尿汞39.565μmol/molCr;ALT61U/L,AST28U/L,BUN7.42mmol/L,SCr67.0μmol/L;血β2-微球蛋白1549.20ng/ml;尿β2-微球蛋白167.0ng/ml。给予二巯基丙磺酸钠治疗,患者症状好转,尿汞趋于正常,复查示肝功能及血、尿β2-微球蛋白水平恢复正常。

Acute mercury poisoning attributed to Chinese herbal medicine pills containing calomel

A 46-year-old man received one Chinese herbal medicine pill prepared by a clinic （ each pill contained approximately 21 mg of calomel ） twice daily and he took 13 pills in total. On day 7,the patient developed dizziness,chest distress,and mouth ulcer accompanied by fever and generalized pain. His symptoms exacerbated and he was hospitalized. His temperature was 37.2℃. Physical examination showed congested erythema,which faded when pressed,in both face and trunk skin and oral-mucosal congestion,as well as gingival swelling. Laboratory tests revealed the following levels：blood mercury 0.029 mg/L,urine mercury 39.565 μmol/molCr,ALT 61 U/L,AST 28 U/L,BUN 7.42 mmol/L,SCr 67.0 μmol/L,blood β2-microglobulin 1 549.20 ng/mL,urine β2-microglobulin 167.0 ng/mL. Unithiol therapy was given. His condition improved,and urine mercury tended to normal. On reexamination,his liver functions,blood and urine β2-microglobulin levels returned to within normal range.