汞中毒相关膜性肾病的临床治疗并文献复习  

Clinical therapy of membranous nephropathy associated with mercury poisoning and literature review

作　　者：罗婷[1,2] 魏日胞[1] 贾楠[1] 王远大[1] 曹勇[2] 马冲[1] 许秋娜[1] 

机构地区：[1]解放军总医院肾病科,北京100853 [2]武警重庆市总队医院,重庆400061

出　　处：《中国药物应用与监测》2013年第6期355-358,共4页Chinese Journal of Drug Application and Monitoring

基　　金：国家科技重大专项(2010ZX9102-204);国家自然科学基金项目(81072914;81273968);军队中医药专项课题(10ZYZ255)

摘　　要：目的：探讨汞中毒相关膜性肾病的治疗方法，为临床提供参考。方法：经查阅相关文献，对汞中毒相关膜性肾病患者的临床表现、肾脏病理特点、治疗预后等进行总结，并对我院2012年12月收治的1例因使用含汞药物导致汞中毒相关膜性肾病患者的实际情况进行分析。结果：文献报道的52例汞中毒引起的肾病病例中，男性14例，女性38例；年龄最小15岁，最大53岁；外用及内服含汞物质3周～6年；37例行肾活检，以膜性肾病为主（33例）；33例膜性肾病患者均给予驱汞治疗及对症支持治疗，其中联合激素治疗者11例，均未使用免疫抑制剂，多数患者经驱汞治疗3～4个疗程临床症状缓解，完全缓解时间小于7个月。我科收治1例36岁男性患者，院外服用含汞中药秘方药丸80 d，肾脏病理表现为膜性肾病Ⅰ期，患者未使用激素及免疫抑制剂，驱汞治疗效果较好。结论：应提高对汞中毒相关膜性肾病的认识，及时行驱汞治疗，预后较好。Objective： To describe the clinical course and management of membranous nephropathy associated with mercury poisoning. Methods： The clinical manifestation and renal pathological characteristic of membranous nephropathy associated with mercury poisoning were reviewed, while the therapy of a similar patient in our hospital was analyzed. Results：There were total 52 cases with 14 males and 38 females of membranous nephropathy associated with mercury poisoning. The age of these patients was between iffteen and iffty-three. The patients used mercury content for 3 weeks-6 years. A total of 37 patients underwent renal biopsy. About 33 cases were diagnosed as membranous nephropathy, they were given mercury displacement treatment and symptomatic support without immunodepressant, among which 11 patients were simultaneously treated with hormone. Most patients improved after 3-4 courses of treatment and completely improved within 7 months. One 36-year-old male patient used mercury traditional Chinese medicine pills for 80 days. Renal pathology showed membranous nephropathyⅠstage. The patient didn＇t use the hormone and immunodepressant. The patient recovered well with the mercury displacement treatment. Conclusion：We should improve the realization of membranous nephropathy associated with mercury poisoning and give mercury displacement treatment in time.

关 键 词：汞中毒 肾炎综合征 膜性肾病 驱汞治疗 

分 类 号：R692.3[医药卫生—泌尿科学]