江苏省32例基于毒物检测确诊毒蕈中毒的临床特征分析

The clinical manifestations of 32 cases with mushroom poisoning in Jiangsu province based on toxicological testing

目的 探讨毒物检测技术在毒蕈中毒临床诊治中的应用价值,分析江苏省确诊毒蕈中毒患者的临床特征。方法 本研究是多中心回顾性队列研究。共收集2020年6月至2023年7月入组参与队列研究的江苏省内10家医院行毒物检测鉴定的32例毒蕈中毒患者的毒检结果、暴露信息及临床特征,分析毒检阳性即检出毒素患者的临床特征,对毒检采样情况与检测结果进行统计分析。结果 本研究共纳入32例进行毒检鉴定的临床诊断毒蕈中毒或可疑中毒患者。收集32例血液样本、31例尿液样本、22例蘑菇样本及1例呕吐物样本。其中蘑菇样本的毒素检测阳性结果18例,占比59.38%,检出α-鹅膏毒肽等8类毒素;1例呕吐物样本检出烟碱;所有患者血液、尿液样本中均未检出常见毒素。结论 通过毒物检测鉴定常见毒蕈毒素种类,能够辅助毒蕈中毒诊断,有助于更迅速、精准的明确蘑菇分型及其所含毒素类别,便于指导临床救治。

Objective To investigate the practical significance of toxicological testing technology in the clinical diagnosis and management of mushroom poisoning,and to analyze the clinical manifestations of the patients with confirmed mushroom poisoning in Jiangsu province.Methods This study was a retrospective cohort study conducted at multiple centers.The outcomes of toxicological testing,exposure details and clinical features were collected in 32 patients with mushroom poisoning who underwent toxicological testing and identification in a total of 10 hospitals located in Jiangsu province,which participated in the cohort study from June 2020 to July 2023.The clinical symptoms of the patients with positive toxicological tests were analyzed,and the correlation between toxicological sampling and test outcomes was analyzed.Results A total of 32 clinically diagnosed patients with mushroom poisoning or suspected poisoning were included in this study for toxicological testing.A total of 32 blood samples,31 urine samples,22 mushroom samples,and 1 vomit sample were collected from 32 patients.Among them,18 mushroom samples were positive in toxicological test,accounting for 59.38%,8 types of toxins includingα-amanitin toxin were detected in 18 mushroom samples;nicotine was detected in one vomit sample;common toxins were not detected in the blood and urine samples of all the patients.Conclusions Identifying mushroom toxins through toxicological testing can assist in the diagnosis of mushroom poisoning,which helps to more quickly and accurately determine the type of mushroom and the type of toxin it contains,and is convenient for guiding clinical treatment.