Gueron M, Margulis G, Sofer S
Division of Cardiology, Soroka University Hospital, Faculty of Health Sciences, Ben-Gurion University of the Negev, Israel.
Toxicon. 1990;28(9):1005-9. doi: 10.1016/0041-0101(90)90138-w.
The echocardiographic and radionuclide angiographic abnormalities in children after scorpion envenomation with L. quinquestriatus, were evaluated. Five children were severely hypertensive, one of them in respiratory failure and another had pulmonary edema. The results revealed poor global contractility 12-15 hr after the sting in three patients. The radionuclide angiograms also revealed poor contractility with low ejection fraction. There was enzymatic evidence of myocardial damage. The changes observed in the echocardiograms and radionuclide angiograms were attributed to catecholamine induced myocardial ischemia. The abnormalities observed suggest that systolic dysfunction plays a role in the pathogenesis of heart failure in scorpion envenomation, in addition to a decrease of left ventricular compliance and increased impedance to left ventricular emptying. The beneficial effects of nifedipine in hypertension and other cardiovascular manifestations justify the routine use of afterload reduction in children with cardiovascular manifestations after scorpion envenomation.
对被金蝎蜇伤的儿童的超声心动图和放射性核素血管造影异常情况进行了评估。5名儿童出现严重高血压，其中1名呼吸衰竭，另1名出现肺水肿。结果显示，3例患者在蜇伤后12 - 15小时整体收缩功能较差。放射性核素血管造影也显示收缩功能较差，射血分数较低。有心肌损伤的酶学证据。超声心动图和放射性核素血管造影中观察到的变化归因于儿茶酚胺诱导的心肌缺血。观察到的异常表明，除左心室顺应性降低和左心室排空阻抗增加外，收缩功能障碍在蝎蜇伤致心力衰竭的发病机制中起作用。硝苯地平对高血压和其他心血管表现的有益作用证明，对蝎蜇伤后有心血管表现的儿童常规使用降低后负荷是合理的。
