CAJ | 학술논문

目的：分析以帕金森综合征为主要表现的汞中毒患者的临床特征，以提高对汞中毒导致帕金森综合征的临床认识。方法收集2005年1月—2014年12月于首都医科大学宣武医院住院确诊的以帕金森综合征为主要表现的汞中毒患者6例，总结分析其临床特征和辅助检查资料。结果6例患者中有3例以震颤起病，3例以运动迟缓、姿势障碍起病。就诊时6例患者的肌张力增高、肌强直表现均较肢体震颤的表现更为突出。患者均接受了头颅MR检查，均无特异性发现。3例患者接受了针极肌电图和神经传导速度检查，无周围神经受累的表现。患者均进行了帕金森病药物的治疗，5例患者对帕金森病药物治疗有效，1例治疗效果不明显。在接受二巯基丙磺酸钠驱汞治疗后，症状可有不同程度的缓解。结论以帕金森综合征为主要表现的汞中毒患者中，肌张力增高和运动迟缓的表现更为突出，多数患者对帕金森病药物治疗有反应，二巯基丙磺酸钠驱汞治疗可进一步缓解临床症状。
목적：분석이파금삼종합정위주요표현적홍중독환자적림상특정，이제고대홍중독도치파금삼종합정적림상인식。방법수집2005년1월—2014년12월우수도의과대학선무의원주원학진적이파금삼종합정위주요표현적홍중독환자6례，총결분석기림상특정화보조검사자료。결과6례환자중유3례이진전기병，3례이운동지완、자세장애기병。취진시6례환자적기장력증고、기강직표현균교지체진전적표현경위돌출。환자균접수료두로MR검사，균무특이성발현。3례환자접수료침겁기전도화신경전도속도검사，무주위신경수루적표현。환자균진행료파금삼병약물적치료，5례환자대파금삼병약물치료유효，1례치료효과불명현。재접수이구기병광산납구홍치료후，증상가유불동정도적완해。결론이파금삼종합정위주요표현적홍중독환자중，기장력증고화운동지완적표현경위돌출，다수환자대파금삼병약물치료유반응，이구기병광산납구홍치료가진일보완해림상증상。
Objective To analyze the clinical characteristics of mercury poisoning patients with Parkinson 's syn-drome, in order to improve the clinical understanding of Parkinson 's syndrome caused by mercury poisoning.Methods From January 2005 to December 2014 , 6 patients who were diagnosed of Parkinson's syndrome due to mercury poisoning in Xuanwu Hospital, Capital University of Medical Sciences were enrolled , summarized and analyzed the clinical features and laboratory examination of these patients.Results 3casesinthese6patientswithonsetoftremor,3caseswithbradykinesiaandpostural instability onset .All of these 6 patients with increased muscle tension , myotonia are more obviously than limbs tremor at be-ginning.All patients underwent MR examination , and no specific findings were found .3 patients underwent needle electrode electromyography and nerve conduction velocity test , and no peripheral nerve involvement was found .All patients received the treatment for Parkinson's disease, effect of Parkinson's disease drugs were found in 5 patients, 1 case with no obvious treatment effect.After DMPS mercury displacement treatment , symptoms can relieve in different degrees .Conclusion Rigidity and bradykinesia were more prominent in Parkinsonism patients due to mercury exposure .Most patients responded to dopamine medication.Parkinsonism could be relieved after chelation therapy .