铊是一种有毒的罕见的重金属,急性铊中毒常见途径有呼吸道、消化道、皮肤吸收,尤以消化道途径最常见。目前铊中毒机制尚未明确,可能与竞争性抑制钾离子、改变脂质体的膜属性、结合含有巯基的酶、损害线粒体功能及结合核黄素而破坏电子传递机制有关。临床上铊的神经毒性表现最突出,当出现胃肠道症状、周围神经病及脱发三联征时要高度怀疑铊中毒。血铊质量浓度大于100 μg/L,尿铊大于200 μg/L具有诊断意义。口服普鲁士蓝及血液净化为临床主要的解毒方法。
Advance in studies on acute intoxication of thallium
Thallium is a toxic and rare heavy metal. There are several common pathways for acute intoxication of thallium to human being, such as respiratory, digestive or dermal route, especially the oral way. It is known that the inhibition of potassium in Na+-K+-ATPase, the alteration of membrane physical properties, the binding with thiol enzyme, the impaired mitochondrial function and interaction with riboflavin to disrupt electron transfer may play a role in thallium toxicity. The exact mechanisms still remain poorly understood. Neurotoxicity is the most prominent clinical symptom for thallium toxicity. When a person showed symptoms of alopecia, peripheral neuropathy together with gastrointestinal disorders, it is reasonable to consider the possibility of thallium toxicity. When the value of thallium level in blood or urinary is more than 100 μg/L or 200 μg/L, it can be used for diagnosis of thallium toxicity. Oral consumption of Prussian and blood purification are main strategies for thallium detoxification.