【摘要】 目的分析急性三甲基锡中毒发病情况及临床特点,为修订国家《急性三甲基锡中毒诊断标准》提供依据。方法收集近年国内外文献报道具有详细临床资料的急性三甲基锡中毒病例52例,对其临床资料进行总结分析。结果三甲基锡中毒的潜伏期可因毒物侵入途径和剂量不同而有较大差异,与剂量呈负相关。发病早期主要症状为乏力伴近事记忆障碍,上述症状出现2~4 d后可突然出现明显精神症状或复杂部分性癫痫发作。低血钾在早期已经发生,引起低钾血症的机制尚未完全明确。尿锡检查无特异性诊断价值。脑电图检查阳性率较高,并与中枢神经系统症状有较密切关系。结论三甲基锡对人体具有高度毒性,职业中毒以亚急性多见;中毒以神经精神症状为主要临床表现,突出表现为精神障碍或癫痫,且与病情的严重度相一致,其发生和程度可作为诊断分级的主要指标。更多还原

【Abstract】 To provide more evidences for the revision of"Diagostic criteria of occupational acute trimethyl tin poisoning",the states of the illness especially the clinical features in 52 cases of acute trimethyl tin poisoning from recent domestic and foreign literature were collected and analyzed.The results showed that the latent period varies with the difference of entry route and exposure dosage,there is some negative correlation with dosage.The dominating clinical manifestation in the early stage of TMT poisoning is fatigue accompanied with recent memory disorder,then the suddenly occurred obviously psychiatric symptoms or the complex partial seizures 2—4 days after onset.Kaliopenia may appear during the early stage of the disease,its pathogenesis is still remained unclear yet.Urinary tin examination is not a specific index for diagnosis of TMT poisoning,while the electroencephalography could always get some positive findings,and seem to have closer relationship with the clinical manifetation of CNS.The conclusion should be that the trimethyltin have higher toxicity to human beings,subacute poisoning may be main mode in occupational intoxication;nervous-mental disorders are the chief clinical manifetations,the outstanding symptoms are psychiatric disorder and seizure,which is paralleled with the serevity of the disease,thereby its degree could be the main standard for the diagnostic classification of actue TMT poisoning.更多还原