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学科主题: 肾脏病学
题名:
汞中毒相关肾小球疾病的临床病理分析
其他题名: Clinicopathological analysis of mercury poisoning-associated glomerulonephropathy
作者: 苏涛1; 刘晓玲1; 张宜苗1; 毛微波1; 刘刚1; 王素霞1; 王汉斌1; 周福德1
关键词: 汞中毒 ; 蛋白尿 ; 肾病,脂性 ; 膜性肾病 ; 局灶节段性肾小球硬化 ; Mercury poisoning ; Proteinuria ; Nephrosis,lipoid ; Membranous nephropathy ; Focal segmental glomerular sclerosis
刊名: 中华肾脏病杂志
发表日期: 2011
DOI: 10.3760/cma.j.issn.1001-7097.2011.05.007
卷: 27, 期:5, 页:333-336
收录类别: 中国科技核心期刊 ; 中文核心期刊 ; CSCD
文章类型: Journal Article
摘要: 目的 了解汞中毒相关肾小球疾病患者的临床病理特点.方法 回顾分析北京大学第一医院2005年1月至2010年5月经临床结合重金属检测诊断的汞中毒相关肾小球疾病患者7例的临床病理资料,包括接触含汞物质的特点、汞中毒及肾小球疾病的临床病理表现.结果 所有患者均为女性,平均年龄(28.9±8.1)岁.均为接触含汞化妆品后5~8个月发病.发病时血汞27.0~98.0μg/L,尿汞34.4~204.0μg/L.初诊症状为水肿,出现不同程度的蛋白尿,血浆白蛋白下降,5例(5/7)达肾病综合征诊断标准.6例肾组织活检病理结果提示,3例为微小病变肾病,2例为膜性肾病,1例局灶节段性肾小球硬化症.全部患者接受驱汞治疗3~7个疗程,血、尿汞下降,尿蛋白于治疗后3~5周内转阴.结论 本研究汞中毒相关肾小球疾病患者均为接触化妆品致病,出现轻度水肿及不同程度的蛋白尿,大部分为肾病综合征范围.肾脏病理为微小病变肾病、膜性肾病及局灶节段性肾小球硬化症.驱汞治疗后可获临床完全缓解. Objective To elucidate the clinical and pathological characteristics of patients with mercury poisoning-associated glomerulonephropathy. Methods Seven patients with mercury poisoning-associated glomerulonephropathy were enrolled in this study. The pattern of mercury exposure, feature of mercury toxicity, and clinicopathological presentation of the kidneys were investigated. Results They were all female, averaged (28.9 ±8.1) years old. Skin-whitening cream was the only cause of mercury poisoning. Proteinuria occurred 5 to 8 months after exposure. Serum mercury were 27.0 to 98.0 μg/L, and spot urinary mercury were 34.4 to 204.0 μg/L. The presentation of all the patients was mild to moderate edema with proteinuria and decreased serum albumin level. Five patients (5/7) were diagnosed as nephrotic syndrome. Six patients underwent renal biopsy: 3 cases with minimal change disease, 2 cases with membranous nephropathy and 1 case with focal segmental glomerular sclerosis. All the patients were administrated chelation therapy with sodium dimercaptopropanal sulfonate or sodium dimercaptosuccinic acid for 3 to 7 courses. They got complete remission by 3 to 5 weeks treatment. Conclusions Patients in this study with glomerulonephropathy induced by mercury poisoning are all from skin-whitening cream exposure. Mild to moderate edema and proteinuria are the common clinical pattern. Minimal change disease, membranous nephropathy and focal segmental glomerular sclerosis are found pathologically. Chelation therapy is effective.
语种: 中文
原文出处: 查看原文
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内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/45967
Appears in Collections:北京大学第一临床医学院_肾脏内科_期刊论文

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作者单位: 1.北京大学肾脏病研究所,卫生部肾脏疾病重点实验室,北京大学第一医院肾内科,100034
2.解放军三0七医院肾内科
3.北京大学第一医院肾病理科,100034

Recommended Citation:
苏涛,刘晓玲,张宜苗,等. 汞中毒相关肾小球疾病的临床病理分析[J]. 中华肾脏病杂志,2011,27(5):333-336.
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