儿童山豆根中毒17例临床报道及分析

The report of 17 cases about Radix Sophorae Tonkinensis poisoning in children

目的报道并分析山豆根中毒患儿的临床及影像学表现,以期减少山豆根中毒的发生及探究其可能存在的致毒机制。方法对近三年西安市儿童医院就诊并住院治疗的山豆根中毒患儿的症状及影像学表现与年龄、体重、用药剂量等进行比较分析。结果山豆根中毒患儿均出现了神经系统症状,部分伴有消化道症状,未发现肝肾功能的损害。实验室检查中有5例患儿未行脑脊液检查,其余12例患儿脑脊液均未见异常;头颅MRI检查中有8例正常,9例异常表现均为小脑半球病变,尤其是齿状核。中毒患儿使用山豆根剂量最大15g,最小4g,平均每公斤体重服用山豆根剂量(0.42±0.10)g;服药时间最短2天,最长14天,平均服用山豆根时间(6.06±2.63)天。结论山豆根中毒反应主要与剂量及服用时间相关,剂量越大,服用时间越长,发生中毒症状越重,且存在蓄积中毒现象。其毒性主要表现为神经毒性,损害部位在小脑。目前认为山豆根所含生物碱是致毒主要成分,但其成分较为复杂,具体为哪类生物碱尚无定论。

Objective Analyzing the clinical features and radiation demonstrations of the poisoned children with Radix Sophorae Tonkinensis,to reduce the drug poisoning and explorthe mechanism.Methods 17 cases were collected in three years,who were hospitalized in Xi’an Children’s Hospital for Radix Sophorae Tonkinensis poisoning. Investigating the the connection between the clinical features and radiation demonstrations of the poisoned children with their age, weight and dosage. Results All the poisoned children had neurological symptoms,some were accompanied by alimentary symptoms,but with no functional lesion of liver and kidney.5 patients with no cerebrospinal fluid examination,the others were all negative. Cranial MRI showed cerebellar hemispheric lesions in 9 patients, especially dentate nucleus. The maximum dose of poisoning is 15 g,minimum dose is 4 g.Conclusion The toxic reaction of Radix Sophorae Tonkinensis is mainly related to dosage and time of use. The higher the dosage, the longer the taking time, the more Serious the poisoning symptoms occur, and there is accumulative poisoning phenomenon. Its toxicity mainly manifests as neurotoxicity, and the damage site is in cerebellum. At present, It’s considered that the alkaloids in Radix Sophorae Tonkinensis are the main toxic components, but it is not yet clear what kind of alkaloids they are.