毒蕈中毒病例中毒特征分析

Poisoning characteristics analysis of mushroom poisoning cases

目的了解近年国内毒蕈中毒病例的临床特征及中毒事件的流行病学特征,为毒蕈中毒的临床分型和预防、治疗提供依据。方法分析总结2000~2013年毒蕈中毒病例中文文献资料,对毒蕈中毒的地区分布、毒蕈种类、主要临床特征、影响的器官系统、治疗方法、鉴定、属种分类等方面进行分析。结果文献共报道毒蕈中毒病例3923例,总体病死率为15.98%;全国共有28个省、自治区/直辖市有毒蕈中毒病例报道,毒蕈中毒发病率和病死率区域分布特征明显;鹅膏菌引起的中毒居首位,临床表现以胃肠道类型和肝肾损害类型多见;尚无特效解毒药;毒蕈鉴定目前主要以形态学鉴定为主,相关毒素检测能力欠缺。结论毒蕈中毒区域特征明显,目前的临床分型方法尚不能涵盖所有的毒蕈中毒表现,毒蕈的鉴定检测水平有待提高。毒蕈中毒救治缺乏有效的治疗手段和解毒药物,救治水平和相关研究亟待提高。

Objective To understand the epidemiological characteristics and clinical features of mushroom poisoning cases in recent years, provide the basis for clinical treatment of mushroom poisoning prevention and classification. Method Analyzed mushroom poisoning cases reported in Chinese journal databases from 2000 to 2013, analyzed regional distribution, mushroom types, main clinical features, effect of organ systems, treatment methods, identifi-cation, classification and other aspects of mushroom poisoning. Result A total of 3923 mushroom poisoning cases were reported, the overall mortality rate was 15. 98%; mushroom poisoning cases were reported in 28 provinces, morbidity and mortality of mushroom poisoning presented different regional distribution; amanita poisoning ranked first, gastrointestinal type and liver and kidney damage types of clinical manifestations were common;there was no specific antidote;mushroom identification at present is mainly morphological identification, lack of the ability to de-tect the related toxins. Conclusion Regional characteristics of mushroom poisoning is obvious, The current clinical typing methods can not cover all of the mushroom poisoning performance. Identification and detection of poisonous mushroom should be improved. There are no effective treatment and specific antidotes of poisoning mushroom, treat-ment and related research needs to be improved.