急性四乙基铅中毒145例临床特点分析  

Literature review on clinical characterization of 145 cases with acute tetraethyl lead poisoning

作　　者：张静波[1] 孙道远[1] 

机构地区：[1]同济大学附属上海市肺科医院中毒科,上海200433

出　　处：《职业卫生与应急救援》2015年第5期322-325,共4页Occupational Health and Emergency Rescue

基　　金：公益性行业科研专项<新增法定职业病防治关键技术研究>(编号:201402021)

摘　　要：目的总结急性四乙基铅中毒的临床特点，为我国修订职业性急性四乙基铅中毒的诊断标准提供依据。方法以“四乙基铅”“四乙基铅中毒”作为关键词，检索国内急性四乙基铅中毒的病例报道，分析其临床表现、实验室检查异常及转归情况。结果纳入18篇文献，对145例四乙基铅急性中毒患者进行调查。早期表现为失眠、多梦、头痛等神经症状，进一步可出现易兴奋、急躁、易怒、焦虑不安或淡漠、对答迟滞等情感障碍，严重者表现为躁动不安、精神错乱、幻觉、妄想、谵妄、人格改变、暴力行为等精神病性症状，可出现癫痫样发作，甚至昏迷。约6％～8％的患者可出现“三低”症状。实验室检查可发现多数患者血铅水平升高，尿铅水平波动较大。结论四乙基铅急性中毒的临床表现以精神症状或意识障碍为主，中毒治疗的关键是早期控制精神障碍。Objective The clinical data of patients diagnosed as acute tetraethyl lead poisoning reported by different authors in Chinese journals were summarized to provide theoretical basis for the revision of the diagnosis criteria of occupational acute tetraethyl lead poisoning in China. Methods The published articles related to tetraethyl lead poisoning were searched in the data bank, including Wanfang network database, CBM network database and CNKI network database, with a key term tetraethyl lead. The clinical data, laboratory examination and prognosis were sumarized. Results A total of 18 articles were found and 145 cases were enrolled. It was noted that the early symptoms of acute tetraethyl lead poisoning were insomnia, dreaminess and headache. Then the patients gradually developed affeetive disorder such as irritability, impatience, anxiety, or indifferent, slowness to respond. Psychotic symptoms such as restless, mental confusion, hallucination, delirium, delusion, personality changes, violence, and epileptic seizure, coma could be found in severe patients,and 6% - 8% of these patients had three- low＇symptoms. Blood lead level increased in the majority of these patients, while urine lead level varied widely. Conclusion The clinical manifestations of acute tetraethyl lead poisoning were psychiatric symptoms and disturbance of consciousness. The key point of treatment is to control mental disorders.

关 键 词：四乙基铅 中毒 精神症状 意识障碍 “三低”症状 

分 类 号：R135.14[医药卫生—劳动卫生]