腺苷蛋氨酸治疗白毒伞中毒的初步探索

The curative effects of transmetil on Amanita verna poisoning

目的观察腺苷蛋氨酸（SAMe）治疗白毒伞中毒的临床疗效。方法回顾性分析12例白毒伞中毒病例资料，按是否使用SAMe治疗分为两组：A组接受洗胃、导泻、补液、利尿、护肝、抗感染及血液净化等治疗；B组在A组治疗的基础上加用SAMe。比较两组病例中毒后第1、3、5及7天肝功能变化及病死率。结果A组6例患者中毒后2人死亡，病死率为33．3％（2／6），2例死亡病例的天冬氨酸转氨酶（AST）和丙氨酸转氨酶（ALT）在3、5d持续增加（5d时〉2000U／L），在7d下降；总胆红素（TBIL）则3、5及7d持续增加。B组6例患者中毒后无死亡病例。SAMe治疗后7d，TBIL下降，5例ALT升高，3例AST降低。结论腺苷蛋氨酸可能对降低白毒伞中毒的病死率起到重要作用。

Objective To observe the curative effects of transmetil on Amanita verna poisoning. Methods Twelve cases with Amanita verna poisoning were reviewed. The patients were divided into 2 groups according to usage of transmetil： Group A was treated with traditional protocol （gastric lavage, catharsis, rehydration, diuresis, anti-infection and hemodialysis）, Group B was treated with traditional protocol combined with transmetil. The liver function changes on the 1st, 3rd, 5th and 7th day after poisoning and the mortality were compared between 2 groups. Results Two cases in group A （6 patients） died. The mortality of group A was 33.3%. The AST levels continued to increase on the 3rd and 5th day, but decreased on the 7th day. TBIL continued to increased on the 1st, 3rd, 5th and 7th day. None in group B died. The TBIL level dropped at 7 d 5 patients showed an increase in ALT at 7 d and 3 patients showed a decrease in AST at 7 d. Conclusion Transmetil may play an important role in reducing the mortality of Amanita verna poisoning.