摘要
目的总结39例汞中毒肾病综合征(NS)患者的临床资料及治疗特点,以提高该病的诊治水平。方法收集2012年7月至2017年9月在解放军总医院第五医学中心治疗的汞中毒NS患者的临床资料,对其病因、临床表现、化验检查、治疗、预后及随访情况进行回顾性分析。结果共收集39例患者,其中女性33例(84.6%),平均年龄(37.44±11.17)岁。表现除全部出现泌尿系统症状外,尚有6例出现神经系统症状、1例出现皮肤表现。汞中毒NS的病理类型主要为微小病变肾病(MCD)和膜性肾病(MN),其中MCD多因患者美容所致,MN多因美容及中药偏方使用不当所致。此外,MCD患者中8例应用激素治疗,显著多于MN中应用激素的患者(4例)。39例患者经过以驱汞为主的综合治疗后,症状逐渐缓解,血汞浓度显著减少,随访发现无明显后遗症。结论美容引起的汞中毒NS的病理类型主要为MN和MCD。中药偏方引起的汞中毒NS主要为MN。及时脱离汞源并行驱汞治疗,症状缓解,预后较好。
Objective To summarize the clinical data and treatment features of 39 cases of mercury poisoning-induced nephrotic syndrome(NS) in order to improve the diagnostic and treatment level of this disease.Methods The clinical data of mercury poisoning-induced NS patients treated in the Fifth Medical Center of PLA General Hospital between July 2012 and September 2017 was collected and the causes,clinical manifestations,laboratory examination,treatment,prognosis and follow-up were analyzed retrospectively.Results There were altogether 39 cases of patients collected,33 of whom were females,accounting for 84.6%,and the average age was 37.44± 11.17 years.Urinary system symptoms were observed in each of these cases,nervous system symptoms in 6 cases and skin manifestations in 1 case.The incidence of membranous nephropathy (MN )and minimal change disease(MCD) was higher than that of other types of NS.MCN mainly occurred in patients who had used cosmetic products containing mercury,while MN was mainly detected in patients for whom mercury poisoning arose from cosmetic products or misuse of traditional Chinese medicine prescriptions.In addition,hormones were used in treating 8 cases of MCD,compared with 4 cases of MN.After removal of mercury,the symptoms of 39 cases were gradually alleviated,with significant reduction in blood mercury concentrations,and no obvious aftereffect was found.Conclusion The pathological types of mercury poisoning nephrotic syndrome are mainly MN and MCD.Symptoms can be gradually alleviated and prognosis is good when the blood mercury is removed by chelating agents in time.
作者
孙亚威
龙剑海
彭晓波
林国东
白丽丽
李嘉玮
王永安
邱泽武
SUN Ya-wei;LONG Jian-hai;PENG Xiao-bo;LIN Guo-dong;BAI Li-li;LI Jia-wei;WANG Yong-an;QIU Ze-wu(State Key Laboratory of Toxicology and Medical Countermeasures,Institute of Pharmacology and Toxicology,Academy of Military Medical Sciences,Academy of Military Sciences,Beijing 100850,China;Poisoning Treatment Department,the Fifth Medical Center,General Hospital of PLA,Beijing 100071,China)
出处
《军事医学》
CAS
北大核心
2019年第1期73-76,共4页
Military Medical Sciences
关键词
汞中毒
血汞
尿汞
化妆品
中草药
肾病综合征
mercury poisoning
blood mercury concentration
urinal mercury concentration
cosmetics
Chinese herbal drugs
nephrotic syndrome
