我国有毒动物、有毒植物、毒蕈中毒现况分析

Analysis of current situation of poisoning caused by poisonous animals,poisinous plants,and poisonous mushrooms in China

目的了解我国有毒动物、有毒植物及毒蕈中毒的现况,以进一步明确有毒生物中毒控制工作方向,为中毒控制关键技术的研究提供科学依据。方法检索中国医院知识资源总库和万方数据库,收集1994至2011年我国公开发表的有毒动物、有毒植物、毒蕈中毒病例/事件的文献,进行回顾性描述流行病学分析。结果收集到符合标准的文献3463篇,共报道中毒患者94 700例,其中有毒动物中毒46 110例,有毒植物中毒37 172例,毒蕈中毒11 418例。中毒主要发生在物种分布相对丰富的南方地区,中毒病例分布地区与物种自然分布地区基本一致。毒物谱相对集中,有毒动物及有毒植物排名前5位的毒物所致中毒病例数分别占这两类中毒病例总数的78.77%(36 321/46 110)及84.03%(31 234/37 172)。导致中毒的有毒动物以毒蛇、鱼胆、河豚为主;有毒植物以豆科、毛茛科植物为主;毒蕈则以未知种类者居多,占77.09%(8802/11 418),已知种类以鹅膏科及牛肝菌科为主。中毒原因主要为意外(50.24%,41 291/82 185)和误食(42.19%,34 670/82 185)。中毒途径以经口为主(70.34%,66 438/94 458)。有毒动物、有毒植物、毒蕈中毒病死率分别为2.52%(1008/39 951)、1.66%(547/33 001)、12.39%(1248/10 076)。结论我国有毒动物、有毒植物、毒蕈中毒危害严重,具有病死率高、地域性强、毒物谱相对集中等特点。因此,今后应加强有毒动物、有毒植物、毒蕈中毒控制工作,建立相应监测体系,开展中毒控制关键技术的研发,并加强毒物识别、毒物危害及预防的宣传教育,以求最大限度降低中毒发生率。

Objective To understand the current situation of poisoning caused by poisonous animals,poisonous plants,and poisonous mushrooms in our country in order to understand the direction of work for controlling poisoning caused by poisonous organisms and to provide scientific basis for the research on key technique for controlling poisoning.Methods China Hospital Knowledge Database and Wanfang Database were searched,and published literature regarding poisoning cases or events caused by poisonous animals,poisonous plants,and poisonous mushrooms in 1994-2011 was collected.The data was analyzed using retrospective descriptive epidemiological methods.Results Three thousand four hundred and sixtythree articles consistent with the criteria were collected and a total of 94 700 poisonous patients were reported,of which 46 110 were produced by poisonous animals,37 172 produced by poisonous plants,and 11 418 produced by poisonous mushrooms.Poisoning mainly occurred in the south area which was abundant in various species and the case distribution was nearly consistent with that of the species.The spectrum of poison were relatively concentrated in several families,and in the number of poisoning cases caused by the top 5 poison categories,poisonous animals and poisonous plants accounted for 78.77% （36 321/46 110）and 84.03% （31 234/37 172） of total number of poisoning cases caused by the 2 kinds of poisonous organisms,respectively.The main categories of poisonous animals causing poisoning were toxic snakes,fish gall bladder,and puffer fish and main plants; the main categories of poisonous plants causing poisoning were Leguminosae and Ranunculaceae.Most poisonous mushrooms poisoning was due to unknown species which accounted for 77.09% （8802/11 418）,and Amanitaceae and Boletaceae were the most common mushrooms in known poisonous mushroom poisoning.The main causes of poisoning were accidents （50.24%,41 291/82 185） and mistaken ingestion （42.19%,34 670/82 185） and the main route of intoxication was oral ingestion （70.34%,66 438/94 458）.The case fatality rates due to poisonous animals,poisonous plants,and poisonous mushrooms were 2.52% （1008/39 951）,1.66% （547/33 001）,and 12.39% （1248/10 076）,respectively.Conclusions Poisoning of poisonous plants,poisonous animals,and poisonous mushrooms could cause serious damage and was characterized by higher fatality rate,significant regionalism,and relatively concentrated poisonous spectrum.Therefore,from now on,the work for controlling poisoning caused by poisonous plants,poisonous animals and poisonous mushrooms should be enhanced; surveillance system should be established; studies on the key technique for controlling poisoning should be conducted;propaganda and education on the identification,hazards,prevention of poisons should be strengthened in order to minimize the incidence of poisoning.