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蘑菇中毒

Mushroom poisoning.

作者信息

Erguven M, Yilmaz O, Deveci M, Aksu N, Dursun F, Pelit M, Cebeci N

机构信息

Department of Pediatrics, Ministry of Health, Goztepe Educational Hospital, Istanbul, Turkey.

出版信息

Indian J Pediatr. 2007 Sep;74(9):847-52. doi: 10.1007/s12098-007-0151-6.

Abstract

OBJECTIVE

We aimed to review characteristics of mushrooms and mushroom poisoning and compare clinical picture, laboratory data, treatment modalities and prognostic factors in children with amanita intoxication and non-amanita mushroom poisoning.

METHODS

We analyzed 39 pediatric patients through 1994-2004, retrospectively from the patient files and evaluated the patients in two groups as patients with amanita intoxication and patients with non-amanita mushroom poisoning. All of the cases were admitted to the hospital in autumn. Twenty three (59%) of the patients were female and 16 (41%) were male. Mean age of the patients was 8.05 +/- 2.10 years.

RESULTS

Amanita phalloides toxin was detected in the serum in 8 patients. Eleven (28%) of the cases were strongly suggestive of amanita poisoning but alpha amanitin level could not be studied. The average time of appearance of symptoms after mushroom consumption, duration of symptoms, hospital stay, serum AST, ALT, PT and creatinine levels were significantly higher in patients with amanita poisoning (p<0.01). Conventional therapy, antidote therapy together with hemoperfusion were carried out in 16 (41%) of the patients. Four of the patients in whose blood amatoxin was detected (50%) and 3 of the patients highly suggestive of amanita poisoning (30%), totally 7 patients died of hepatic coma. The average time of admission to hospital, mean AST, ALT, creatinine and PT values at 3rd day were significantly higher in patients who died of hepatic coma. Prognosis was better in case of early admittance to hospital in patients with amanita poisoning.

CONCLUSION

Early diagnosis and treatment in mushroom poisoning can be life saving. Public awareness is very important in prevention of intoxication as well as encouraging early admission to hospitals.

摘要

目的

我们旨在回顾蘑菇及蘑菇中毒的特征,并比较鹅膏菌中毒儿童与非鹅膏菌蘑菇中毒儿童的临床表现、实验室数据、治疗方式及预后因素。

方法

我们回顾性分析了1994年至2004年期间39例儿科患者的病历,并将患者分为鹅膏菌中毒组和非鹅膏菌蘑菇中毒组进行评估。所有病例均在秋季入院。23例(59%)患者为女性,16例(41%)为男性。患者平均年龄为8.05±2.10岁。

结果

8例患者血清中检测到鬼笔鹅膏毒素。11例(28%)病例强烈提示鹅膏菌中毒,但无法检测α-鹅膏毒肽水平。食用蘑菇后出现症状的平均时间、症状持续时间、住院时间、血清谷草转氨酶(AST)、谷丙转氨酶(ALT)、凝血酶原时间(PT)和肌酐水平在鹅膏菌中毒患者中显著更高(p<0.01)。16例(41%)患者接受了常规治疗、解毒治疗及血液灌流。检测出血清中含有鹅膏毒素的患者中有4例(50%)以及高度提示鹅膏菌中毒的患者中有3例(30%),共7例患者死于肝昏迷。死于肝昏迷的患者入院平均时间以及第3天的平均AST、ALT、肌酐和PT值显著更高。鹅膏菌中毒患者早期入院预后较好。

结论

蘑菇中毒的早期诊断和治疗可挽救生命。公众意识对于预防中毒以及鼓励早期入院非常重要。

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