Jones G M, Vale J A
National Poisons Information Service (Birmingham Centre), City Hospital, United Kingdom.
J Toxicol Clin Toxicol. 2000;38(2):123-8. doi: 10.1081/clt-100100926.
USES: Diquat (1,1'-ethylene-2,2'-bipyridilium) is a nonselective bipyridyl herbicide, related structurally to paraquat, which is used both as a contact herbicide and a preharvest desiccant. In comparison to paraquat, diquat is used much less widely in agriculture.
Diquat is a potent redox cycler and is readily converted to a free radical which, in reaction with molecular oxygen, generates superoxide anions and subsequently other redox products. These products can induce lipid peroxidation in cell membranes, and potentially cause cell death.
Over the period 1968-1999, only 30 cases of diquat poisoning were reported in detail in the literature, of which 13 (43%) were fatal. Local and systemic effects have been reported following diquat exposure, with systemic features being invariably associated with ingestion. In severe and usually fatal cases, gastrointestinal mucosal ulceration, paralytic ileus, hypovolemic shock, acute renal failure, and coma have been reported.
After rapid confirmation of the diagnosis using a qualitative urine test, gut decontamination may be considered in patients who present within 1 hour of a life-threatening ingestion (>6 g). Supportive measures including fluid and electrolyte replacement should then be employed. Although hemofiltration and hemodialysis are of proven value if renal failure supervenes, there is no clinical evidence that hemodialysis or hemoperfusion removes toxicologically significant amounts of diquat, thereby reducing the risk of organ failure and preventing a fatal outcome in severe cases.
用途：敌草快（1,1'-亚乙基-2,2'-联吡啶鎓）是一种非选择性联吡啶类除草剂，结构上与百草枯相关，用作触杀型除草剂和收获前干燥剂。与百草枯相比，敌草快在农业中的使用范围要小得多。
敌草快是一种强效氧化还原循环剂，很容易转化为自由基，该自由基与分子氧反应生成超氧阴离子，随后生成其他氧化还原产物。这些产物可诱导细胞膜脂质过氧化，并可能导致细胞死亡。
在1968年至1999年期间，文献中仅详细报道了30例敌草快中毒病例，其中13例（43%）死亡。已报道敌草快暴露后有局部和全身影响，全身症状总是与摄入有关。在严重且通常致命的病例中，已报道有胃肠道粘膜溃疡、麻痹性肠梗阻、低血容量性休克、急性肾衰竭和昏迷。
使用定性尿液检测快速确诊后，对于在危及生命的摄入（>6克）后1小时内就诊的患者，可考虑进行肠道去污。然后应采取包括补充液体和电解质在内的支持措施。虽然如果发生肾衰竭，血液滤过和血液透析已被证明有价值，但没有临床证据表明血液透析或血液灌流能清除具有毒理学意义的大量敌草快，从而降低器官衰竭的风险并防止严重病例出现致命后果。
