White J
Toxinology Department, Women's and Children 's Hospital, North Adelaide, Australia.
Ther Drug Monit. 2000 Feb;22(1):65-8. doi: 10.1097/00007691-200002000-00014.
Venomous and poisonous animals are a significant cause of global morbidity and mortality. This Seminar will cover selected aspects of these animals, their venoms/poisons, and their clinical impact on humankind, from a global perspective, but with a distinctive Australian flavor and a clinical emphasis. Venomous snakes are found throughout most of the world, including many oceans, and have evolved a variety of highly effective toxins and methods of delivery. Their impact on humans is considerable, most current data suggesting they cause in excess of 3 million bites per year with more than 150,000 deaths. Particularly in the rural tropics, snakebite morbidity and mortality has a significant human medical and economic toll. The major groups of snakes causing bites are the vipers, the elapids (cobra type), the sea snakes, the side-fanged vipers, and the back-fanged colubrids. Australian venomous snakes are nearly all elapids and have evolved some of the most toxic of all snake venoms. Their effects include potent procoagulants and anticoagulants, neurotoxins, myotoxins, and nephrotoxins, but a distinct absence of the major local necrotoxins found in some non-Australian elapids and many vipers. The effect of these toxins on humans is not limited to envenoming, for the toxins are proving invaluable as research tools and diagnostic agents, and may even have a future as precursors of therapeutic agents. Because of the high toxicity and diversity of Australian elapids, a variety of monovalent antivenoms have been developed. There is also a venom detection kit to determine the type of snake and allow targeted antivenom therapy. The kit has also increased information available on diagnostic patterns of envenoming for each species. Australia is also home to the world's most lethal spiders, the funnel webs of eastern Australia, as well as the red back spider, the single most common reason for antivenom treatment in Australia. The latter spiders have been accidently exported to Japan. Within the marine environment exist a vast array of toxic animals, both poisonous and venomous, which not only cause morbidity and mortality in humans, but offer an incredibly rich array of valuable toxins. Australian waters contain some of the most lethal and medically problematic species, presenting a diverse range of clinical problems.
有毒动物是全球发病和死亡的一个重要原因。本次研讨会将从全球视角，以独特的澳大利亚特色并侧重临床的方式，涵盖这些动物的某些方面、它们的毒液/毒素以及它们对人类的临床影响。毒蛇遍布世界大部分地区，包括许多海洋，并且进化出了多种高效毒素和排毒方式。它们对人类的影响相当大，目前大多数数据表明，它们每年导致超过300万次咬伤，死亡人数超过15万。特别是在热带农村地区，蛇咬伤的发病率和死亡率给人类医疗和经济带来了巨大损失。造成咬伤的主要蛇类群体包括蝰蛇、眼镜蛇科（眼镜蛇类）、海蛇、侧牙蝰蛇和后牙游蛇科。澳大利亚的毒蛇几乎都是眼镜蛇科，并且进化出了一些毒性最强的蛇毒。它们的毒液包括强效促凝剂和抗凝剂、神经毒素、肌毒素和肾毒素，但明显缺少一些非澳大利亚眼镜蛇科和许多蝰蛇所具有的主要局部坏死毒素。这些毒素对人类的影响不仅限于中毒，因为这些毒素作为研究工具和诊断试剂正证明具有极高价值，甚至未来可能成为治疗药物的前体。由于澳大利亚眼镜蛇科毒性高且种类多样，已开发出多种单价抗蛇毒血清。还有一种毒液检测试剂盒，用于确定蛇的种类并进行针对性的抗蛇毒血清治疗。该试剂盒还增加了每种蛇中毒诊断模式的可用信息。澳大利亚也是世界上最致命蜘蛛的家园，如澳大利亚东部的漏斗网蜘蛛，以及红背蜘蛛，后者是澳大利亚抗蛇毒血清治疗最常见的单一原因。后一种蜘蛛已意外出口到日本。在海洋环境中存在大量有毒动物，既有有毒的也有毒液的，它们不仅会导致人类发病和死亡，还提供了极其丰富的有价值毒素。澳大利亚海域包含一些最致命且在医学上最成问题 的物种，呈现出各种各样的临床问题。
