Eddleston M, Ariaratnam C A, Sjöström L, Jayalath S, Rajakanthan K, Rajapakse S, Colbert D, Meyer W P, Perera G, Attapattu S, Kularatne S A, Sheriff M R, Warrell D A
Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Headington, Oxford OX3 9DU, UK.
Heart. 2000 Mar;83(3):301-6. doi: 10.1136/heart.83.3.301.
To describe the cardiac arrhythmias, electrolyte disturbances, and serum cardiac glycoside levels seen in patients presenting to hospital with acute yellow oleander (Thevetia peruviana) poisoning and to compare these with published reports of digitalis poisoning.
Case series.
Medical wards of Anuradhapura District General Hospital, Sri Lanka, and coronary care unit of the Institute of Cardiology, National Hospital of Sri Lanka, Colombo, the national tertiary referral centre for cardiology.
351 patients with a history of oleander ingestion.
ECG and blood sample analysis on admission.
Most symptomatic patients had conduction defects affecting the sinus node, the atrioventricular (AV) node, or both. Patients showing cardiac arrhythmias that required transfer for specialised management had significantly higher mean serum cardiac glycoside and potassium but not magnesium concentrations. Although there was considerable overlap between groups, those with conduction defects affecting both sinus and AV nodes had significantly higher mean serum cardiac glycoside levels.
Most of these young previously healthy patients had conduction defects affecting the sinus or AV nodes. Relatively few had the atrial or ventricular tachyarrhythmias or ventricular ectopic beats that are typical of digoxin poisoning. Serious yellow oleander induced arrhythmias were associated with higher serum cardiac glycoside concentrations and hyperkalaemia but not with disturbances of magnesium.
描述因急性黄花夹竹桃（黄花夹竹桃）中毒入院患者出现的心律失常、电解质紊乱及血清强心苷水平，并将这些情况与已发表的洋地黄中毒报告进行比较。
病例系列研究。
斯里兰卡阿努拉德普勒地区总医院的内科病房以及斯里兰卡科伦坡国立医院心脏病研究所的冠心病监护病房，该研究所是全国心脏病三级转诊中心。
351例有夹竹桃摄入史的患者。
入院时的心电图和血样分析。
大多数有症状的患者存在影响窦房结、房室（AV）结或两者的传导缺陷。出现需要转至专科治疗的心律失常的患者，其平均血清强心苷和钾浓度显著更高，但镁浓度无明显差异。尽管两组之间存在相当大的重叠，但影响窦房结和房室结的传导缺陷患者，其平均血清强心苷水平显著更高。
这些既往健康的年轻患者中，大多数存在影响窦房结或房室结的传导缺陷。相对较少患者出现地高辛中毒典型的房性或室性快速心律失常或室性早搏。严重的黄花夹竹桃所致心律失常与血清强心苷浓度升高和高钾血症相关，但与镁紊乱无关。
