Clinical Features And Risk Factors Of Renal Injury In Patients With Chronic Mercury Poisoning

BackgroundIn recent years, it was reported that more and more patients because of heavy metal mercury poisoning.The incidence of mercury poisoning showed a sustained growth trend in China, so it got more attention of government and society. Especially the occupation mercury poisoning has become a serious public health hazard. At the same time, the proportion of non-occupation mercury poisoning is also increasing. For example in the process of some diseases of diagnosis and treatment, there was inappropriate medication. Using oral mercury, inorganic mercury compounds and some herbal remedies containing mercury to treat diseases such as psoriasis, acne, sinusitis, asthma, of these measurements leaded to accumulation of mercury in the body. Else many women wanted to become more white by using whitening cosmetics with mercury, then they were the source of non occupation mercury poisoning. In a word, The hazard of mercury has become an important and common concern topic.The characteristics of mercury metabolism in vivo include a long half-life and slow metabolism, toxic effect, more complications, limited treatment methods and long mercury poisoning hospitalization time. Higher mercury treatment expenditure has caused a huge economic burden to the country, society, enterprises and families mercury poisoning patients. In addition, the incidents of the group with mercury poisoning in the province Guangdong, Jilin, Henan ect, al. even caused some social panic. The kidney is one of the target organs of mercury poisoning, Metal complexing agents used in the treatment of mercury poisoning can also be passed through the kidney metabolism, then further increased the damage of the kidney.At present, there are many studies on the mechanism of the nervous system and renal injury of mercury poisoning, but little studies on the risk factors and clinical manifestations of renal damage in patients with chronic mercury poisoning. Therefore, through the study of risk factors of renal damage in patients chronic mercury related with poisoning, to find out the risk factors,recognize significant clinical signs and symptoms, early intervention, reduce exposure to risk factors. When the body has significance clinical symptoms, the doctor can protect the kidneys by strengthen treatment, to reduce the degree of kidney damage and the risk of complications and disability. ObjectiveThrough the analysis of clinical symptoms and signs, laboratory examination and auxiliary examination of the poisoning patients with chronic mercury, to explore the risk factors of renal damage in these patients weith mercury poisoning.Then it's helpful to do early intervention these patients, reduce chronic mercury poisoning renal injury patients and renal damage, provide a reference for the further when these patients with significant clinical symptoms and signs, some meaningful exposure risk factors. MethodA total of 93 chronic mercury poisoning cases were collected in Henan province institute of occupation disease prevention research(Henan province occupation disease hospital) in the year 2010-2015. The research analyzed these clinical, laboratory data and symptoms, such age, sex, weight, time, the way of mercury exposure and smoking, blood pressure and other basic information, clinical symptoms(headache, body pain, edema, the spirit of personality changes, dizziness, insomnia, memory loss) and signs(positive examination of the nervous system, hands shaking, trembling tongue, nystagmus and pigmentation), urine volume changes and laboratory examination indexes(serum albumin, total protein, in vivo urine mercury value(Hg U), blood urea nitrogen(BUN), serum creatinine(S-Cr), blood uric acid(UA), total bilirubin(TBIL), total cholesterol(CHOL), low density lipoprotein(LDL), urine routine) and auxiliary examination results(electrocardiogram(ECG), abdominal ultrasound. renal biopsy The pathological examination results). These patients can be divided into two groups,that is renal injury group and normal kidney group by the standard rule of renal injury index. It used different statistical methods depended the type of data.Through SPSS17.0 statistical software to analyze the 31 indicators of chronic mercury poisoning patients with kidney damage and significant clinical symptoms and signs. Measurement data to `x ± s(standard ± deviation), between the two groups using T test, count data using chi square(?2) test, with a P value of less than 0.05 was considered significant, analysis of whether there is a significant difference between the 31 indicators of kidney damage and kidney poisoning patients in normal group and chronic mercury, then these significant indexes by Logistic regression analysis, the confounding factors and bias, and find out the risk of kidney injury in chronic mercury poisoning patient factors. Result1. The incidence of renal injury in patients with chronic mercury poisoning was 26.88%, the normal prevalence of chronic kidney disease was 10.8%, chronic mercury poisoning renal damage in patients with normal prevalence and prevalence of chronic kidney disease odds ratio(OR) is 2.49, the OR 95% confidence interval: [1.14-5.24];2. There was no significant difference in age, sex and body weight between the kidney injury group and the normal group in the chronic mercury poisoning(P>0.05);3. Chronic mercury poisoning between patients with kidney injury group and normal kidney group in smoking, hypertension, BUN, S-Cr, UA, Hg U, neurological examination positive, urine volume changes, edema, headache, body pain, mental personality changes, total protein and albumin decreased significantly lower index. Meaning, through the Logistic analysis of smoking, hypertension, BUN value increased and UA value increased, low plasma albumin, nervous system to positive and statistically significant edema check(P<0.05);4. Poisoning time, the way of mercury contact(skin, respiratory and digestive tract), style of mercury(mercury, mercury ion atomic species), pigmentation, dizziness, insomnia, memory loss, hands shaking, trembling tongue, eyes fibrillation, CHOL increased, TBIL increased and LDL increased white abnormal electrocardiogram(myocardial ischemia, block, prolonged Q-T interval, QRS wave low voltage, sinus bradycardia, sinus tachycardia) and other indicators, had no significant difference in patients with chronic mercury poisoning between kidney injury group and normal kidney group(P>0.05). Conclusion1. The incidence of renal injury in patients with chronic mercury poisoning was 26.88%, chronic mercury poisoning patients with kidney damage is 2.49 times the normal people with chronic kidney injury.2. High blood pressure, smoking, UA increased and low plasma albumin are positive in patients are renal injury patients with chronic mercury poisoning risk factors; Edema and neurological examination positive are significant positive signs.3. Gender, age, weight, poisoning time, the way of mercury contact, style of mercury, increased CHOL and LDL increased, TBIL increased, Hg U increased, S-Cr increased, total protein decreased, abnormal ECG are not the main factor of kidney injury in patients with clinical manifestations, urine volume changes, headache, body pain, mental personality changes, memory loss, insomnia, pigmentation, hands shaking, trembling tongue, eyes fibrillation are not significant positive signs.