Bergamo Poison Control Center, Ospedali Riuniti, Bergamo, Italy.
Clin Toxicol (Phila). 2010 Jun;48(5):463-5. doi: 10.3109/15563650.2010.487487.
Yew (Taxus baccata) is a conifer known to be toxic since ancient times. Taxine A and taxine B, the toxic alkaloids of Taxus, block cardiac sodium and calcium channels causing nausea, vomiting, abdominal pain, cardiac arrhythmias, respiratory distress, coma, seizures, and death in yew poisoning.
A 44-year-old male farmer was admitted to the hospital because of a suspected myocardial infarction. First bradycardia and then ventricular tachycardia were present and a severe right ventricular dilatation with biventricular dysfunction was observed but with normal coronary arteriography. He was resistant to conventional therapy and, 6 h after hospital admission, extracorporeal support with membrane oxygenation was applied. The patient recovered. Nine days later, a large number of yew leaves were unexpectedly observed in his feces. Botanical and laboratory analysis confirmed the poisoning. Blood (651 ng/mL) and urinary (5.6 mcg/mL) levels of 3,5-dimethoxyphenol (metabolite of taxicatine) were greater than previously reported in lethal cases. The patient was transferred to a psychiatric unit 17 days after admission.
Intensive treatment of severe cardiovascular symptoms with antiarrhythmic drugs, temporary pacemaker, intra-aortic balloon pump, extracorporeal membrane oxygenation, and extracorporeal life support can be life-saving even after a potentially lethal ingestion of T. baccata leaves.
紫杉（Taxus baccata）是一种自古以来就被认为有毒的针叶树。紫杉中的毒性生物碱紫杉碱 A 和紫杉碱 B 会阻断心脏的钠和钙通道，导致紫杉中毒患者出现恶心、呕吐、腹痛、心律失常、呼吸困难、昏迷、癫痫发作和死亡。
一名 44 岁男性农民因疑似心肌梗死入院。入院时首先出现心动过缓，随后出现室性心动过速，观察到严重的右心室扩张伴双心室功能障碍，但冠状动脉造影正常。他对常规治疗有抵抗力，入院后 6 小时，应用膜氧合体外生命支持。患者康复。9 天后，他的粪便中意外发现了大量紫杉叶。植物学和实验室分析证实了中毒。血液（651ng/mL）和尿液（5.6mcg/mL）中 3,5-二甲氧基苯酚（紫杉碱的代谢物）的水平高于先前报道的致死病例。入院 17 天后，患者被转至精神科病房。
即使摄入了可能致命剂量的紫杉叶，通过抗心律失常药物、临时起搏器、主动脉内球囊泵、体外膜氧合和体外生命支持等方法，对严重心血管症状进行强化治疗，可能挽救生命。
