二巯丙磺钠治疗汞中毒患者有效性安全性的回顾性分析

Retrospective Analysis of Safety and Efficacy of Sodium Dimercaptopropane Sulfonate in Treatment of Mercury Poisoning Patients

目的:了解二巯丙磺钠注射液治疗汞中毒患者的疗效及不良反应发生情况,分析其临床安全性及有效性。方法:收集2013年1月~2017年6月因尿汞升高收治入院的179例患者(200例次)的电子病历,按职业病相关诊断标准将患者分为职业病组和非职业病组,分析使用二巯丙磺钠注射液治疗期间尿汞变化、不良反应发生情况,并评价疗效。结果:179例患者(200例次)中职业病患者130例(148例次),非职业病患者49例(52例次),确诊为汞中毒的63例次,经1~6个疗程治疗后临床症状大都治愈或好转,患者出院前尿汞值较入院时显著下降(P<0.001),职业病且非患者出院前尿汞值显著低于职业病组患者(P<0.001)。治疗总有效率为96.50%。收集到113例次患者治疗前和治疗1 d后的尿汞值,治疗1 d后的尿汞值显著高于治疗前(P<0.001)。患者尿汞值在第1~2个疗程下降最快。200例次患者中有34例次发生药品不良反应,发生率为17.00%,均为轻度一般不良反应,转归良好。女性患者不良反应发生率高于男性。结论:二巯丙磺钠注射液用于治疗汞中毒患者是安全有效的,能够明显加速患者尿汞排泄速度,降低患者体内汞含量。

Objective： To observe the therapeutic effect and adverse reaction of the treatment of mercury poisoning by sodium dimercaptopropane sulfonate, and to analyze its clinical safety and efficacy. Methods： The electronic medical records of 179 patients（200 cases） who had mercury poisoning were enrolled from January 2013 to June 2017. They were divided to occupational group and non occupational group. Analyzed the changes in urinary mercury during treatment, the occurrence of adverse events, and the outcome of the use of sodium dimercaptopropane sulfonate injection. Results： There were 130 occupational patients （148 cases）, and 49 non occupational patients （52 cases）. 63 cases of mercury poisoning were confirmed. After 1 to 6 courses of treatment, most clinical symptoms were cured or improved. The urinary mercury de- creased significantly than hospitalized（ P 〈 0.001 ）, and the urinary mercury of non occupational disese patients were signif- icantly lower than occupational disease patients （ P 〈 0.001 ）. The total effective rate was 96.50%. 113 cases＇ urinary mercury in total were collected before and after 1 day treatment, the urinary mercury of after treatment was significant higher than before（P 〈 0.001 ）. Urinary mercury levels in the first and two courses of treatment decline fastest. Within the 200 patients who received mercury sulfide injection, there were 34 patients with adverse reactions caused by dimercaptopropane injection, the incidence of adverse reactions was 17.00% , all of which were mild general adverse reactions and had a good results. The incidence of adverse events in female patients was higher than that in male patients. Conclusion ： Sodium dim- ercaptopropane sulfonate was safe and effective for the treatment of mercury poisoning patients. It could obviously accelerate the urine mercury excretion rate, reduce mercury levels in patients.