饮水型地方性砷中毒引起神经系统损害的临床观察及研究  

Clinical observation and study of nervous system lesions for drinking water type of endemic arsenism

作　　者：李泽宇[1,2] 郑宏君[1,2] 韩萍[1,2] 王凤歧 马恒之[1,2] 孙萍 鄂兰萍 武克恭[1,2] 

机构地区：[1]内蒙古医学院第一附属医院神经内科 [2]内蒙古地方病研究所

出　　处：《中华神经科杂志》1998年第2期95-97,共3页Chinese Journal of Neurology

摘　　要：目的研究饮水型地方性砷中毒神经系统损害的临床表现、实验室检查特征及变化规律。方法对饮用高含砷水（０．５０ｍｇ／Ｌ～１．４３ｍｇ／Ｌ）３～１０年的２７７例地方性砷中毒患者和饮用非高含砷水（＜０．０３ｍｇ／Ｌ）６１名健康者做对照研究。经全面神经系统检查，测定饮用水、尿液、血液及头发中砷含量，部分进行脑电图、肌电图、视觉诱发电位检测及眼底摄影。结果病区患者组视力下降、眼底视神经萎缩、嗅觉减退、听力下降、雷诺氏现象、末梢神经炎高于对照组（Ｐ＜０．０１～０．０５）；眼底视乳头周边、黄斑区周围异常色素沉着检出率也高于对照组（Ｐ＜０．０５）；病区患者组色素带宽度值与体内砷蓄积量、发砷含量之间有相关性，Ｐ＜０．０１～０．０５。结论慢性砷中毒可导致脑神经、周围神经及植物神经损害，造成视乳头周边及黄斑区周边色素异常沉积。Objective To study the research on clinical manifestations of the nervous system lesions developed from the local drinking water type of endemic arsenism and to suggest some clinical features for the diagnosis of chronic arsenism. Method The study was carried out in a group of 277 patients drinking the water with relatively high arsenic contents (0.5 mg/L～1.43 mg/L) which were confirmed by the epidemic investigation to compare with a group of 61 healthy people drinking tap water (0.03 mg/L). The arsenic contents of the drinking water, the urine, the blood and the hair specimens of the two groups were tested respectively. The two groups had also undergone the examinations with EEG, EMG, vision induction electric potential (VIP) and eyeground photography. Results Brown pigmented zones around the neuropapilli of the ocular fundi and pigmented depositions around the retinal yellow spots were discovered in the patients and a few persons in the healthy group. Comparing the patient group with the healthy group ,the two groups showed obvious stastistics difference ( P <0.05). the value of the pigmented zone of eyegrounds had obvious correlation with the total amount of arsenic accumulation and the content of hair arsenism ( P <0.01～0.05). Hyposia and optic atrophy were noted in the patient group and the extention of VIP P100 latent showed great difference in the two groups ( P <0.01). Other symptoms found were hyposmia, hypoacusis and abnormal perspiration of extremities, Reynaud′s phenomenon and periphery neuritis ( P <0.01～0.05). The posteriortibial nerve conduction was delayed on the early stage of perphery neuritis. Insomnia was one of the chief symptoms indicating the presence of the central nervous system lesions. In the patient group EEG showed the boundary line type and mild abnormalities ( P <0.05). Conclusion The obvious manifestations of peripheral nerve lesions of drinking water type of arsenism to appear is about six years or so when the content of arsenic was up to 2 981 3 077 mg. Dr

关 键 词：地方性砷中毒 饮水 神经系统损害 

分 类 号：R599.9[医药卫生—内科学]