【摘要】 目的总结铊中毒的神经精神表现,以期引起神经精神科医生对铊中毒的警惕。方法复习8例铊中毒患者的临床资料及相关文献,探讨铊中毒的机制以及与神经系统的关系;铊中毒的神经精神表现及病理。结果8例患者中急性重度中毒3例,表现为腹痛、恶心、呕吐;烦躁、谵妄、昏迷、抽搐;呼吸衰竭、血压降低、心动过速,均在短期死亡。5例为亚急性或慢性中毒。其临床表现以周围神经、视神经或中枢神经损害为主,部分患者有毛发脱落。8例中有6例误诊为其他神经系统疾病,2例疑诊铊中毒,因条件所限当时未确诊。5例存活病例经对症治疗,临床症状明显好转,个别病例遗留部分后遗症。结论因误服与投毒所致铊中毒由于缺乏接触史,给临床诊断带来很大困难。对原因不明的周围神经、中枢神经损害患者应警惕铊中毒的可能,若有毛发脱落,更应怀疑铊中毒,可结合血尿铊定量确诊。更多还原

【Abstract】 Objective To summarize the neuropsychic manifestations of thallium poisoning to attract attention of neuropsychiatrists. Methods Eight cases of thallium poisoning were reported. The manifestations of thallium poisoning and the relative literatures were reviewed. We discussed the relationship between mechanism of thallium poisoning and nervous system,neuropsychic manifestation and pathology of thallium poisoning. Results Three of 8 cases were acute and severe,presenting bellyache,nausea,vomit, fantod,delirium,coma,convulsion,respiratory failure,low blood pressure and tachycardia. They all died in a short period. The other 5 cases were subacute or chronic. Most of them manifested the impairment of central nervous system,peripheral nerve and optic nerve. Some of them had alopecia.Six of 8 cases were misdiagnosed as other neurological diseases. Two were suspicious of thallium poisoning,but failed to be diagnosed for the time being. The 5 survivors of 8 cases obviously restored after heteropathy. Few cases had neurologic sequelae. Conclusions For lacking of contact history, it is difficult to diagnose thallium poisoning caused by malicious contamination or accidental poisoning. Attention should be paid to those patients with indefinite damage of peripheral and central nervous system. When alopecia appears,thallium poisoning must be suspicious of. For the suspected cases,it is necessary to measure the thallium level in blood and urine in order to verify the diagnosis.更多还原