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亚洲货船上的胂中毒

Arsine toxicity aboard the Asiafreighter.

作者信息

Wilkinson S P, McHugh P, Horsley S, Tubbs H, Lewis M, Thould A, Winterton M, Parsons V, Williams R

出版信息

Br Med J. 1975 Sep 6;3(5983):559-63. doi: 10.1136/bmj.3.5983.559.

Abstract

Eight sailors on board the Asiafreighter were exposed to arsine that had escaped from a cylinder in the cargo hold. Four suffered severe toxicity and within a few hours had developed fever, weakness, nausea, vomiting, diarrhoea, abdominal pain, and haemoglobinuria. These patients had pronounced intravascular haemolysis, which in one patient was complete. This patient was also stuporose and anoxic, a condition attributed to failure of oxygen transport and sludging of red cell debris in the cerebral and pulmonary circulations, but he regained a normal level of consciousness after exchange transfusion. Evidence of marrow depression was present: the reticulocyte response to the haemolysis was poor and there was a thrombocytopenia. All four patients developed renal failure, one being totally anuric for five weeks. Two patients developed peripheral neuropathy, and one was still severely disabled six months after the incident. The other four patients had a similar, though less severe, illness.

摘要

一艘亚洲货船上的8名船员接触到了从货舱一个钢瓶中泄漏出来的胂。其中4人中毒严重,数小时内就出现了发热、虚弱、恶心、呕吐、腹泻、腹痛和血红蛋白尿。这些患者发生了明显的血管内溶血,其中1例患者完全溶血。该患者还处于昏迷和缺氧状态,这种情况归因于氧运输失败以及红细胞碎片在脑循环和肺循环中淤滞,但他在换血输血后恢复了正常意识水平。存在骨髓抑制的证据:网织红细胞对溶血的反应较差,且有血小板减少。所有4例患者都出现了肾衰竭,其中1例完全无尿达5周。2例患者出现了周围神经病变,1例在事件发生6个月后仍严重残疾。另外4例患者病情相似,但程度较轻。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/985f/1674520/52c41f1d105f/brmedj01463-0012-a.jpg

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