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[蘑菇中毒诊断中的鹅膏菌素测定]

[Amanitin determination in mushroom poisoning diagnostics].

作者信息

Gomółka Ewa, Szpak Dorota, Morawska Agnieszka, Wilimowska Jolanta

机构信息

Pracownia Toksykologii Analitycznej i Terapii Monitorowanej, Katedra Toksykologii i Chorób, Srodowiskowych, UJCM w Krakowie.

出版信息

Przegl Lek. 2010;67(8):576-9.

Abstract

There are some serious poisonings with toxic mushroom species in Poland every year. Good prognostics in the cases is correlated to short time from mushroom consumption to hospitalization, correct distinguish not specific gastrointestinal and Amanita phalloides syndrome and immediately specific treatment. The purpose of the paper was to make appraisal of usefulness of amanitin blood and urine determination and transaminases activity determination (ALT, AST) in diagnostics of mushroom poisoned patients up to three days after mushroom consumption. The material was twenty two retrospective histories of mushroom poisoned patients treated in the years 2007-2008. Amanitin blood and urine determinations were made by ELISA method. Urine amanitin results in samples collected within 40 h from mushroom consuming were positive in all Amanita phalloides syndrome cases. Serum amanitin determination was not useful for the diagnostics. Trans-aminases activity determinations let to distinguish Amanita phalloides syndrome on the second and the third day after mushroom consumption. In the first poisoning phase (within 24 h), the ALT and AST activities were in normal ranges and only amanitin urine determination let to confirm or exclude Amanita phalloides poisoning. Amanitin urine determinations were useful to take fast decision about specific treatment and avoid internal organs dysfunctions.

摘要

波兰每年都会发生一些由有毒蘑菇种类导致的严重中毒事件。这些病例的良好预后与从食用蘑菇到住院的时间短、正确区分非特异性胃肠道症状和毒鹅膏综合征以及立即进行特异性治疗相关。本文的目的是评估鹅膏毒肽血液和尿液测定以及转氨酶活性测定(ALT、AST)在食用蘑菇后三天内对蘑菇中毒患者诊断的有用性。研究材料为2007年至2008年治疗的22例蘑菇中毒患者的回顾性病史。采用ELISA法进行鹅膏毒肽血液和尿液测定。在所有毒鹅膏综合征病例中,食用蘑菇后40小时内采集的尿液样本中鹅膏毒肽检测结果均为阳性。血清鹅膏毒肽测定对诊断无用。转氨酶活性测定有助于在食用蘑菇后的第二天和第三天区分毒鹅膏综合征。在中毒的第一阶段(24小时内),ALT和AST活性在正常范围内,只有鹅膏毒肽尿液测定能够确认或排除毒鹅膏中毒。鹅膏毒肽尿液测定有助于快速决定是否进行特异性治疗并避免内脏器官功能障碍。

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