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[摩洛哥蝎子蜇伤的临床演变及循环毒液水平]

[Clinical evolution and circulating venom levels in scorpion envenomations in Morocco].

作者信息

el Hafny B, Ghalim N

机构信息

Unité des venins et toxines, Département de recherche, Institut Pasteur du Maroc, Casablanca, Maroc.

出版信息

Bull Soc Pathol Exot. 2002 Aug;95(3):200-4.

Abstract

We conducted a clinical and biological study in Morocco in order to assess the efficacy of antivenom therapy against scorpion stings. Epidemiological and clinical data were collected in 275 patients envenomed by Androctonus mauretanicus mauretanicus and Buthus occitanus scorpions. Patients received antivenom or symptomatic drugs. Blood samples were collected upon hospital admission, at 1 hr and 3 hrs after the treatment. An enzyme linked immunosorbent assay (ELISA) was set up to quantify the venom levels in serum of envenomed patients. Mean serum venom concentrations showed an association between clinical signs and the venom level. The venom concentration at admission, in patients who received 10 ml of antivenom, was significantly reduced after antivenom therapy. The decrease was less important in patients who received only 2 to 5 ml of antivenom. No difference was shown in the venom concentration of patients not treated with antivenom. The clinical signs decreased significantly after antivenom treatment. The absence of antivenom administration increased the risk to develop clinical signs at the end of hospitalisation. This risk was much higher when the delay between scorpion sting and hospital admission increased. The results of our study have demonstrated the efficacy of antivenom in reducing circulating venom and symptoms. Antivenom therapy is more efficient when administered as soon as possible after envenomation and with appropriate quantities of antivenom. This study is favourable to the use of SAS but a prospective study would be useful to confirm these data.

摘要

我们在摩洛哥开展了一项临床与生物学研究,以评估抗蛇毒血清疗法对蝎子蜇伤的疗效。收集了275例被毛里塔尼亚杀人蝎和奥克西坦斯钳蝎蜇伤中毒患者的流行病学和临床数据。患者接受了抗蛇毒血清或对症药物治疗。在患者入院时、治疗后1小时和3小时采集血样。建立了酶联免疫吸附测定(ELISA)法来定量中毒患者血清中的毒液水平。平均血清毒液浓度显示出临床体征与毒液水平之间的关联。接受10毫升抗蛇毒血清治疗的患者入院时的毒液浓度在抗蛇毒血清治疗后显著降低。而仅接受2至5毫升抗蛇毒血清治疗的患者,毒液浓度下降幅度较小。未接受抗蛇毒血清治疗的患者毒液浓度无差异。抗蛇毒血清治疗后临床体征显著减轻。未使用抗蛇毒血清会增加住院末期出现临床体征的风险。当蝎子蜇伤与入院之间的时间间隔增加时,这种风险会更高。我们的研究结果证明了抗蛇毒血清在降低循环毒液和症状方面的疗效。中毒后尽快给予适量抗蛇毒血清,抗蛇毒血清疗法会更有效。本研究支持使用抗蛇毒血清,但需要进行前瞻性研究来证实这些数据。

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