Nuffield Department of Clinical Medicine, University of Oxford, John Radcliffe Hospital, Oxford, UK.
Lancet. 2010 Jan 2;375(9708):77-88. doi: 10.1016/S0140-6736(09)61754-2.
Snake bite is a common and frequently devastating environmental and occupational disease, especially in rural areas of tropical developing countries. Its public health importance has been largely ignored by medical science. Snake venoms are rich in protein and peptide toxins that have specificity for a wide range of tissue receptors, making them clinically challenging and scientifically fascinating, especially for drug design. Although the full burden of human suffering attributable to snake bite remains obscure, hundreds of thousands of people are known to be envenomed and tens of thousands are killed or maimed by snakes every year. Preventive efforts should be aimed towards education of affected communities to use proper footwear and to reduce the risk of contact with snakes to a minimum through understanding of snakes' behaviour. To treat envenoming, the production and clinical use of antivenom must be improved. Increased collaboration between clinicians, epidemiologists, and laboratory toxinologists should enhance the understanding and treatment of envenoming.
蛇伤是一种常见且经常造成严重后果的环境和职业性疾病,尤其是在热带发展中国家的农村地区。医学科学对其公共卫生重要性一直重视不够。蛇毒富含对广泛组织受体具有特异性的蛋白质和肽类毒素,这使得蛇伤在临床上具有挑战性,在科学上也具有吸引力,尤其是在药物设计方面。尽管因蛇伤而遭受痛苦的全部负担仍不明确,但据了解,每年有数十万人被蛇咬伤,数万人因蛇伤而死亡或致残。预防工作应针对受影响社区进行教育,让他们使用适当的鞋子,并通过了解蛇的行为将与蛇接触的风险降至最低。为了治疗蛇伤,必须改进抗蛇毒血清的生产和临床应用。临床医生、流行病学家和实验室毒素学家之间加强合作,应能增进对蛇伤的认识和治疗。