Razi Vaccine and Serum Research Institute, Karaj, Iran.
Toxicon. 2012 Feb;59(2):249-56. doi: 10.1016/j.toxicon.2011.11.004. Epub 2011 Nov 17.
Immunotherapy is the only specific treatment for scorpion sting. In the present study, protective effects of polyvalent antivenom against hemodynamic disturbances, biomarkers (troponin T, creatinine kinase isoenzyme MB, Lactate dehydrogenase) changes, electrocardiogram abnormalities and histopathological complications in heart and lung induced by Mesobuthus eupeus scorpion venom was investigated in anesthetized rabbits. Twenty four rabbits were randomized into four equal groups: six rabbits in control group received 1 ml ultra-pure water subcutaneously (group 1). Group two received LD50 of venom (4.5 mg/kg). In the third and fourth groups, 5 ml of scorpion antivenom was administrated intravenously simultaneous with venom injection and 60 min following envenomation, respectively. Results of the present study indicate significant decrease in hemodynamic parameters following envenomation in the second group of animals. Venom injection caused edema, myocytolysis, coagulation necrosis, hemorrhage in heart as well as edema, hemorrhage and vascular thrombus in lungs. Although envenomed rabbits presented rises in LDH and TnT but no alteration in CK-MB was observed. Electrocardiogram monitoring of rabbits showed ST elevation and inverted T waves. Simultaneous administration of antivenom and venom prevented entirely the clinical signs, hemodynamic disturbances, markers changes, ECG abnormalities and histopathological damages. Delayed immunotherapy gradually ameliorated clinical signs, hemodynamic disturbances and markers changes related to envenomation. Histopathological evaluation showed slight alterations such as mild myocytolysis in heart and mild edema in lung following delayed immunotherapy. In conclusion, scorpion antivenom administration has preventive, neutralizing and curative properties for M. eupeus scorpion envenomation, if it would be applied at optimum time, dose and route.
免疫疗法是治疗蝎子蜇伤的唯一特效疗法。本研究旨在探讨多价抗蛇毒血清对麻醉兔 Mesobuthus eupeus 蝎毒液引起的心、肺血流动力学紊乱、生物标志物（肌钙蛋白 T、肌酸激酶同工酶 MB、乳酸脱氢酶）变化、心电图异常和组织病理学并发症的保护作用。将 24 只兔子随机分为 4 组，每组 6 只：对照组 1 组皮下注射 1ml 超纯水（n=6）；第 2 组给予 LD50 毒液（4.5mg/kg）；第 3、4 组在注射毒液的同时和毒液注射后 60min 静脉注射 5ml 蝎抗蛇毒血清。结果表明，第 2 组动物在毒液注射后血流动力学参数明显下降。毒液注射引起心脏水肿、肌溶解、凝固性坏死、出血，以及肺水肿、出血和血管血栓形成。尽管中毒兔的 LDH 和 TnT 升高，但 CK-MB 无变化。心电图监测显示 ST 段抬高和 T 波倒置。同时给予抗蛇毒血清和毒液可完全预防临床症状、血流动力学紊乱、标志物变化、心电图异常和组织病理学损害。延迟免疫治疗逐渐改善了中毒相关的临床症状、血流动力学紊乱和标志物变化。组织病理学评价显示，延迟免疫治疗后心脏有轻度肌溶解，肺有轻度水肿等轻微改变。结论：如果在最佳时间、剂量和途径使用，蝎抗蛇毒血清对 M. eupeus 蝎毒液具有预防、中和和治疗作用。
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