2015—2017年广西壮族自治区钩吻碱中毒事件分析

Analysis of gelsemine poisoning events in the Guangxi Zhuang autonomous region during 2015-2017

目的归纳2015—2017年广西钩吻碱导致暴发事件特点,为防控钩吻碱中毒提供科学依据。方法收集2015—2017年广西监测、处理的钩吻碱中毒事件,分析事件发生原因、可疑暴露食品、临床特征、治疗方法等。结果 2015—2017年累积暴露27人,发病21人,死亡10人,病死率47.6%,平均潜伏期30 min。病例分布中,男性占61.9%(13/21),50～60岁占47.6%(10/21),外地占71.4%(15/21),农民工占61.9%(13/21)。主要临床症状为头晕、视力模糊(均占100.0%,21/21)。暴露环节中,钩吻根茎、花粉和叶子均出现中毒,自泡米酒中毒病死率最高(77.8%,7/9)。结论广西钩吻碱中毒途径众多,外来人口(农民工)更容易误食含钩吻碱植物,应加强宣传提高防范意识。

Objective To analyze the outbreaks causing by gelsemine in Guangxi in 2015-2017 and provide a scientific basis for the prevention and control of gelsemine poisoning. Methods The monitoring data of gelsemine poisoning of Guangxi in 2015-2017 was collect, and the causes, suspicious food, clinical characteristics, treatment method were analyzed. Results During 2015 and 2017, 27 people were exposed, 21 were attacked and 10 were dead with the fatality rate of 47.6%, the mean incubation period was 30 minutes. In the case distribution, men accounted for 61.9%(13/21), 50-60 years old accounted for 47.6%(10/21). Nonlocal people accounted for 71.4%(15/21), and migrant workers accounted for 61.9%(13/21). The main clinical symptoms were dizziness and blurred vision(100.0%, 21/21). All the roots, pollen and leaves of the gelsemine plants were poisonous during the exposure. The self-brewing wine with gelsemine got the highest fatality rate(77.8%, 7/9). Conclusion There were different ways of gelsemine poisoning. Nonlocal people(migrant workers) were more likely to suffer from gelsemine plants. Health education should be strengthened to improve the awareness of prevention.