School of Medicine, University of Colorado Denver, Aurora, CO, USA.
Ann Pharmacother. 2011 Dec;45(12):1491-8. doi: 10.1345/aph.1Q424. Epub 2011 Nov 24.
Black widow spider (Latrodectus spp.) envenomation remains the most clinically significant spider envenomation in the US. The syndrome is characterized by painful muscle rigidity and autonomic disturbances. Treatment has ranged from symptomatic care to administration of specific antivenom. Declining antivenom availability and, possibly, the fear of hypersensitivity allergic reactions, has limited antivenom use in the US.
To describe Latrodectus spp. exposures and the subsequent treatment reported to US poison centers; the secondary objective was to identify factors associated with shorter duration of symptoms (<24 hours).
All Latrodectus spp. exposures reported to the National Poison Data System (NPDS) between January 1, 2000, and December 31, 2008, were reviewed. Cases with at least minor clinical effects due to Latrodectus spp. exposure were extracted. Descriptive statistics were generated. The probability that symptom duration was less than 24 hours was modeled, using logistic regression.
From 2000 through 2008, a total of 23,409 Latrodectus spp. exposures were reported in 47 states; 9872 cases had at least minor clinical effects and were included in the subsequent analysis. Exposures peaked in September and fell to a nadir in January and February. Fifty-eight percent of the cases involved males, and the mean (SD) age was 31.5 (17.4) years. Sixty-five percent of the patients had minor clinical effects, 33.5% had moderate effects, 1.4% had major effects, and there were no deaths. Antivenom use was associated with symptom duration of less than 24 hours in moderate and major outcome groups. There was no evidence of shorter symptom duration in patients who received benzodiazepines or calcium. Adverse drug reactions were more common in patients receiving benzodiazepines and antivenom.
In the US, most symptomatic Latrodectus spp. exposures reported to the NPDS are minor. Few patients receive antivenom, although antivenom is associated with shorter symptom duration among moderate and major outcomes.
黑寡妇蜘蛛（Latrodectus spp.）螫伤仍然是美国最具临床意义的蜘蛛螫伤。该综合征的特征是疼痛性肌肉僵硬和自主功能紊乱。治疗范围从对症治疗到使用特定的抗蛇毒血清。抗蛇毒血清的供应减少，以及对过敏反应的恐惧，可能限制了抗蛇毒血清在美国的使用。
描述美国中毒控制中心报告的黑寡妇蜘蛛（Latrodectus spp.）暴露情况及随后的治疗情况；次要目的是确定与症状持续时间（<24 小时）较短相关的因素。
对 2000 年 1 月 1 日至 2008 年 12 月 31 日期间向国家毒物数据系统（NPDS）报告的所有黑寡妇蜘蛛（Latrodectus spp.）暴露情况进行了回顾。提取因黑寡妇蜘蛛（Latrodectus spp.）暴露而至少有轻微临床影响的病例。生成描述性统计数据。使用逻辑回归模型对症状持续时间<24 小时的概率进行建模。
2000 年至 2008 年，美国 47 个州共报告 23409 例黑寡妇蜘蛛（Latrodectus spp.）暴露情况；9872 例有至少轻微的临床影响，并纳入了随后的分析。暴露情况在 9 月达到高峰，在 1 月和 2 月降至最低点。58%的病例为男性，平均（SD）年龄为 31.5（17.4）岁。65%的患者有轻微的临床影响，33.5%有中度影响，1.4%有严重影响，无死亡病例。在中度和严重结局组中，使用抗蛇毒血清与症状持续时间<24 小时相关。接受苯二氮䓬类药物或钙剂的患者无证据表明症状持续时间更短。药物不良反应更常见于接受苯二氮䓬类药物和抗蛇毒血清的患者。
在美国，向 NPDS 报告的大多数有症状的黑寡妇蜘蛛（Latrodectus spp.）暴露情况较轻。尽管抗蛇毒血清与中度和严重结局的症状持续时间较短相关，但很少有患者接受抗蛇毒血清治疗。
