6例重度三甲基氯化锡中毒患者4年随访分析

Follow up analysis of 6 patients with severe trimethyltin chloride poisoning for 4 years

目的了解重度三甲基氯化锡(TMT)中毒患者4年间健康变化。方法于2016年8月,将赣南医学院第一附属医院收治的6例重度TMT中毒患者分别编序号为1、2、3、4、5、6号,对患者在中毒后0.5、2、4年进行随访及对比分析,随访内容包括:症状程度、《简易精神智能检查量表》(MMSE)评分及《改良Rankin量表》(mRS)评分、头颅磁共振成像(MRI)、脑电图等。结果6例患者头晕、头痛、胸闷、心悸、恶心及呕吐等症状逐渐减轻。1、2、3号患者的言语障碍、记忆力下降症状逐渐加重,MMSE及mRS评分逐渐降低;4、5、6号患者言语障碍好转,但记忆力下降、MMSE及mRS评分仍平定位轻度认识功能障碍。1、2、3号患者脑萎缩加重,表现为海马、颞叶、岛叶、小脑萎缩明显及脑室扩大;4、5、6号患者脑萎缩变化不明显。结论重度TMT中毒后期神经毒性症状仍然严重,且神经毒性时间长。

Objective Objective to investigate the health changes of patients with severe trimethyltin chloride(TMT)poisoning in four years.Methods Six patients with severe TMT poisoning treated in the First Affiliated Hospital of Gannan Medical College in August 2016 were numbered 1,2,3,4,5 and 6 respectively.The patients were followed up 0.5,2 and 4 years after poisoning and compared and analyzed.The follow-up contents include:symptom degree,score of simple mental intelligence examination scale(MMSE)and modified Rankin Scale(MRS),cranial magnetic resonance imaging(MRI),EEG,etc.Results The symptoms of dizziness,headache,chest tightness,palpitation,nausea and vomiting decreased gradually in 6 patients.The symptoms of speech disorder and memory decline in No.1,2 and 3 patients gradually increased,and the scores of MMSE and Mrs gradually decreased;Patients No.4,5 and 6 had improved speech disorder,but their memory decreased,MMSE and Mrs scores were still flat,and mild cognitive impairment.The brain atrophy of No.1,2 and 3 patients was aggravated,which showed obvious atrophy of hippocampus,temporal lobe,insular lobe and cerebellum and enlargement of ventricle;There was no significant change in brain atrophy in No.4,5 and 6 patients.Conclusion The neurotoxic symptoms in the later stage of severe TMT poisoning are still serious,and the neurotoxic time is long.