[Mercury concentration in cerebrospinal fluid in patients with chronic mercury poisoning].
OBJECTIVE
To investigate the changes of mercury (Hg) levels in cerebrospinal fluid (CSF) in patients with chronic mercury poisoning and elucidate the neurotoxic mechanism of mercury.


METHODS
Nine patients with chronic mercury poisoning (poisoning group) as well as eight patients without exposure to mercury were included in this study. Mercury concentrations of 24 hour urine (U-Hg) and CSF (CSF-Hg) were measured with cold-vapor atomic absorption spectrometry-alkali stannous chloride method. The concentration of blood (B-Hg) at the same day was measured with cold-vapor atomic absorption spectrometry-acidic stannous chloride method. In five patients of poisoning group, these concentrations before chelation therapy were compared with those after chelation therapy.


RESULTS
The levels of B-Hg, U-Hg, and CSF-Hg in poisoning group (250.00 +/- 48.54, 160.07 +/- 91.15, 20.22 +/- 10.21 nmol/L, respectively) were significantly higher than those in control group (81.04 +/- 63.01, 24.73 +/- 9.96 nmol/L, undetectable, respectively; P < 0.01). In nine patients of poisoning group, CSF-Hg concentrations were correlated with B-Hg (r = 0.675, P < 0.05), but not U-Hg. After chelation therapy with dimercaptopropane sulfonate in five patients of poisoning group, the levels of B-Hg, U-Hg, and CSF-Hg were decreased significantly (P < 0.05). The reduction of CSF-Hg was not related with B-Hg and U-Hg.


CONCLUSIONS
CSF-Hg concentration in chronic mercury poisoning patient is increased with the rise of B-Hg, but not U-Hg. When the levels of B-Hg and U-Hg drop to normal, the CSF-Hg level is still high enough to be detected. It indicates that mercury is combined with protein after entering brain and this complex is difficult to cross through blood-cerebral barrier. The complex may cause neuromuscular disorder and fremitus in chronic mercury poisoning.
Liu
Wei-wei
WW
Guangzhou Prevention & Treatment Center for Occuqational Disease, Guangzhou 510620, China.
Jiang
Chao-qiang
CQ
Hu
Zhi-bing
ZB
Zhang
Cheng
C
Xu
Qi-rong
QR
Zhou
Gang
G
D000328:Adult; D000931:Antidotes / Q000627:therapeutic use; D002908:Chronic Disease; D005260:Female; D006801:Humans; D008297:Male; D008628:Mercury / Q000134:cerebrospinal fluid*; D008630:Mercury Poisoning / Q000134:cerebrospinal fluid* / Q000188:drug therapy; D008875:Middle Aged; D016273:Occupational Exposure; D013054:Spectrophotometry, Atomic; D014494:Unithiol / Q000627:therapeutic use
D000931:Antidotes; D014494:Unithiol; D008628:Mercury