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[1例乌头碱中毒伴双向性室性心动过速患者应用利多卡因治疗的病例]

[A case of aconitine poisoning accompanied by bidirectional ventricular tachycardia treated with lidocaine].

作者信息

Tsukada K, Akizuki S, Matsuoka Y, Irimajiri S

机构信息

Department of Internal Medicine, Kawasaki Municipal Hospital.

出版信息

Kokyu To Junkan. 1992 Oct;40(10):1003-6.

PMID:1439251
Abstract

A rare case of aconitine poisoning accompanied by bidirectional ventricular tachycardia was reported. A 67-year-old male ate several leaves of a wild plant which had been collected in Fukushima Prefecture, Japan. About 90 minutes later, he felt numbness and weakness of the limbs and vomiting took place, and he was admitted to our hospital. The blood pressure was 80/60mmHg, and the electrocardiogram showed multiple premature ventricular contractions and bidirectional ventricular tachycardia. After bolus injection of lidocaine, continuous administration of the drug was started. Immediately after starting the treatment, the arrhythmia disappeared and hemodynamic changes improved. Thereafter the wild plant was ascertained to be a species of Aconitium. Diagnosis of aconitine poisoning was made. According to the fact that aconitine acts as a agonist of Na-channel receptor, antiarrhythmic agents which belong to Vaughan-Williams' classification I might be the first choice for the therapy of aconitine induced arrhythmias.

摘要

报告了一例罕见的乌头碱中毒伴双向室性心动过速病例。一名67岁男性食用了几片采自日本福岛县的野生植物叶子。约90分钟后,他感到四肢麻木、无力并出现呕吐,随后被送入我院。血压为80/60mmHg,心电图显示频发室性早搏和双向室性心动过速。静脉推注利多卡因后,开始持续给药。治疗开始后,心律失常立即消失,血流动力学变化改善。此后,该野生植物被确认为乌头属的一种。诊断为乌头碱中毒。鉴于乌头碱作为钠通道受体激动剂的作用,属于Vaughan-Williams分类I类的抗心律失常药物可能是治疗乌头碱所致心律失常的首选药物。

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