二巯基丙磺酸钠注射液治疗汞中毒患者药物不良反应及影响因素分析  

Adverse drug reactions in patients treated with sodium dimercaptosulphonate injection for mercury poisoning and influencing factors

作　　者：陈晔 吉卉霞 刘丹丹 沈阳 CHEN Ye;JI Huixia;LIU Dandan;SHEN Yang(Department of Occupational Disease,Nanjing Prevention and Treatment Center for Occupational Diseases,Nanjing,Jiangsu 210042,China)

机构地区：[1]南京市职业病防治院职业病科,南京江苏210042

出　　处：《环境与职业医学》2024年第9期1020-1024,共5页Journal of Environmental and Occupational Medicine

摘　　要：[背景]既往二巯基丙磺酸钠(DMPS)驱汞治疗发生药物不良反应(ADR)的报道多见于职业性汞中毒。近年来因使用含汞化妆品致生活性汞中毒日渐增多,临床上使用DMPS驱汞过程发生ADR并不少见。[目的]探讨慢性汞中毒及汞接触患者使用DMPS驱汞治疗后发生ADR的情况及影响因素。[方法]收集2017年6月至2023年12月于南京市职业病防治院职业病科因汞中毒住院驱汞治疗的患者。收集住院患者人口统计学、基线特征、治疗方案等信息,随访时收集二手烟、居住地、血型等未在住院时采集的信息。根据使用DMPS后是否发生ADR分为两组,比较两组患者的临床特征,采用二元logistic回归法分析DMPS治疗后发生ADR相关的影响因素。[结果]共纳入72例患者,其中26例驱汞过程中发生ADR,共29例次,主要为皮疹11例次(37.9%),发热5例次(17.2%),恶心4例次(13.8%)。半数ADR患者发生在第2、3疗程,分别为7人(26.9%)、9人(34.6%)。发生ADR的未绝经22例女性中,13例(59.1%)在月经前一周使用DMPS。logistic回归分析显示吸烟(OR=27.911,95%CI:2.835~725.809)、O型血(OR=6.885,95%CI:2.014~26.896)与使用DMPS后发生ADR相关。[结论]使用DMPS驱汞治疗后发生ADR概率不低,但以轻症为主,经及时治疗缓解,预后较好。O型血、吸烟及女性患者在月经前一周使用DMPS驱汞治疗可能更易发生ADR。[Background]Adverse drug reactions(ADRs)to sodium dimercaptosulphonate(DMPS)mercury removal treatment have been reported in occupational mercury poisoning.In recent years,the number of cases of mercury poisoning due to mercury-containing cosmetics has been increasing,and ADRs to the use of DMPS are common in clinical practice.[Objective]To investigate the occurrence of ADRs and the influencing factors in patients with chronic mercury poisoning and mercury exposure treated with DMPS for mercury removal.[Methods]Patients treated with DMPS due to mercury poisoning at the Occupational Disease Department of Nanjing Prevention and Treatment Center for Occupational Diseases from June 2017 to December 2023 were included in the study.Information on demographics,baseline characteristics,and treatment regimens was collected at admission.Information on secondhand smoke,place of residence,and blood groups not collected at admission was collected in followup.The patients were divided into two groups according to whether ADRs occurred after the use of DMPS and were compared for clinical characteristics,and the influencing factors related to the occurrence of ADRs after DMPS treatment were analyzed by binary logistic regression.[Results]A total of 72 patients were enrolled in the study,of which 26 reported ADRs during mercury removal.A total of 29 ADRs occurred,mainly rash in 11 cases(37.9%),fever in 5 cases(17.2%),and nausea in 4 cases(13.8%).Most ADRs occurred in the second course(7 cases,26.9%)and the third course(9 cases,34.6%).Of the 22 non-menopausal women who experienced ADRs,13(59.1%)used DMPS in the week prior to menstruation.The logistic regression analysis showed that smoking(OR=27.911,95%CI:2.835,725.809)and blood type O(OR=6.885,95%CI:2.014,26.896)were associated with elevated occurrence of ADRs after DMPS treatment.[Conclusions]The probability of ADRs after DMPS treatment is not low,but mild presentations are predominant and resolved with immediate treatment,with a favourable prognosis.The O blood group,smoking ind

关 键 词：二巯基丙磺酸钠 汞中毒 驱汞治疗 药物不良反应 预后 

分 类 号：R11[医药卫生—公共卫生与预防医学]