健康儿童地高辛中毒的急性毒性观察

Two unusual cases of acute digoxin intoxication caused by accidental mistaken

目的 观察健康儿童误服大量地高辛引起中毒的急性毒性。方法 详细记录临床症状 ,同时检测血清地高辛浓度、血钾浓度和检查心电图变化。结果 两病例地高辛急性中毒后 ,都表现为频繁呕吐、厌食、乏力、嗜睡等 ,心脏毒性表现为过缓性心律失常 :窦性静止、窦房阻滞或房室传导阻滞 ;随着血清地高辛浓度的降低 ,两病例上述症状明显减轻。当血清地高辛浓度小于 3.0 μg·L-1时 ,两病例上述症状大部分消失。结论 健康儿童地高辛中毒的急性毒性作用表现在消化、神经、循环等系统 ,主要表现为心脏毒性 。

OBJECTIVE: To observe the toxic manifestations of digoxin (DGX) in two children after orally overdose of DGX. METHODS: The clinical toxic symptoms and signs were observed. At the same time, the concentrations of DGX and potassium in serum were determined, the electrocardiogram (ECG) was recorded. RESULTS: After orally taking an overdose of DGX, the children showed continual vomiting, anorexia, fatigue, somnolence etc. Heart toxicity displayed brady arrhythmias: sinus standstill, sinoauricular block or atrioventricular block. The higher serum DGX concentration was, the worse its toxicity was. It was obvious that the above symptoms eased off while the serum DGX concentration decreased. When serum DGX concentration was below 3.0 μg &middot L-1, the above symptoms were almost disappeared. CONCLUSION: The acute toxicity of DGX in two children was mostly related to the systems of digestion, CNS and circulation. It showed especially heart toxicity and closely correlative with the serum DGX concentration.