The effect of sodium maleate on the renal deposition and excretion of mercury.
The effect of sodium maleate on the renal deposition and excretion of mercury.
复制标题
马来酸钠对肾脏沉积和排泄汞的影响。
DOI：
10.1111/j.1476-5381.1967.tb00420.x
复制
发表时间：
1967
期刊：
影响因子：
--
通讯作者：
L. Magos
中科院分区：
文献类型：
--
作者：
T. Clarkson;L. Magos
了解金属在肾脏沉积和排泄的机制，为解决重金属中毒的两个实际问题提供了合理的基础；通过测量尿液排泄来估计暴露程度，并寻找能够加速金属从体内排泄的化学试剂。就汞而言，解决这些问题的方法一直是经验性的，因为汞的肾脏沉积和肾脏排泄的机制尚不清楚。最近的研究对广泛接受的理论（Staemler，1956）提出了质疑，即汞首先被肾小球过滤，然后被肾小管细胞吸收。这一理论在急性汞中毒的情况下可能成立，此时肾小球膜可能受损，但在其他情况下可能不适用。例如，肾脏中的汞首先沉积在间质毛细血管的内皮细胞中，随后才出现在肾小球簇中（Wockel、Stegnar 和 Janisch，1961）。汞先于菊粉出现在尿液中，表明金属直接穿过管状壁运输（Mambourg & Raynaud，1965；Vostal，1966）。此外，Berlin & Gibson (1963) 表明，血浆中 99% 以上的汞不可超滤，并且输尿管结扎不会影响肾脏中的蓄积率。由于输尿管结扎后肾小球滤过仍在继续（Salomon & Lanza，1962），如果肾小球滤过理论成立，肾脏摄取就会减少。
Knowledge of the mechanism of renal deposition and excretion of metals provides a rational basis for dealing with two practical problems in heavy metal intoxication; estimation of the degree of exposure from measurements of urinary excretion and the search for chemical agents capable of accelerating the excretion of the metal from the body. In the case of mercury the approach to these problems has been empirical because the mechanism of kidney deposition and of renal excretion of mercury is unknown. Recent work has cast doubt on the widely accepted theory (Staemmler, 1956) that mercury is first filtered by the glomerulus and then taken up by the tubular cells. This theory may hold in the case of acute mercury poisoning when the glomerular membrane may be damaged but it is probably not applicable otherwise. For example, the first deposits of mercury in the kidney are seen in the endothelial cells of the interstitial capillaries and only later in the glomerular tufts (Wockel, Stegnar & Janisch, 1961). Mercury appears in the urine in advance of inulin, suggesting a transport of the metal directly across the tubular walls (Mambourg & Raynaud, 1965 ; Vostal, 1966). Furthermore, Berlin & Gibson (1963) have shown that more than 99% of the mercury in the plasma is not ultrafiltrable and that ligation of the ureter does not influence the rate of accumulation in the kidney. Since some glomerular filtration continues after ureteral ligation (Salomon & Lanza, 1962) a reduction in kidney uptake should occur if the glomerular filtration theory is true.