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响尾蛇和矛头蝮蛇毒所致急性肾损伤:流行病学、临床表现及治疗综述

Acute kidney injury caused by Crotalus and Bothrops snake venom: a review of epidemiology, clinical manifestations and treatment.

作者信息

Albuquerque Polianna L M M, Jacinto Camilla N, Silva Junior Geraldo B, Lima Juliana B, Veras Maria do Socorro B, Daher Elizabeth F

机构信息

Toxicological Assistance Center, Instituto Dr José Frota, FortalezaCeará, Brazil.

出版信息

Rev Inst Med Trop Sao Paulo. 2013 Sep-Oct;55(5):295-301. doi: 10.1590/S0036-46652013000500001.

Abstract

Ophidic accidents are an important public health problem due to their incidence, morbidity and mortality. An increasing number of cases have been registered in Brazil in the last few years. Several studies point to the importance of knowing the clinical complications and adequate approach in these accidents. However, knowledge about the risk factors is not enough and there are an increasing number of deaths due to these accidents in Brazil. In this context, acute kidney injury (AKI) appears as one of the main causes of death and consequences for these victims, which are mainly young males working in rural areas. Snakes of the Bothrops and Crotalus genera are the main responsible for renal involvement in ophidic accidents in South America. The present study is a literature review of AKI caused by Bothrops and Crotalus snake venom regarding diverse characteristics, emphasizing the most appropriate therapeutic approach for these cases. Recent studies have been carried out searching for complementary therapies for the treatment of ophidic accidents, including the use of lipoic acid, simvastatin and allopurinol. Some plants, such as Apocynaceae, Lamiaceae and Rubiaceae seem to have a beneficial role in the treatment of this type of envenomation. Future studies will certainly find new therapeutic measures for ophidic accidents.

摘要

由于蛇咬伤事故的发生率、发病率和死亡率,它们是一个重要的公共卫生问题。在过去几年里,巴西登记的此类病例越来越多。多项研究指出了了解这些事故的临床并发症及适当处理方法的重要性。然而,对风险因素的了解还不够,巴西因这些事故导致的死亡人数也在增加。在这种背景下,急性肾损伤(AKI)成为这些受害者主要的死亡原因和后果之一,受害者主要是在农村地区工作的年轻男性。在南美洲,矛头蝮属和响尾蛇属的蛇是蛇咬伤事故中导致肾脏受累的主要原因。本研究是关于矛头蝮属和响尾蛇属蛇毒所致急性肾损伤的文献综述,涉及多种特征,重点强调针对这些病例的最合适治疗方法。最近开展了一些研究,寻找治疗蛇咬伤事故 的辅助疗法,包括使用硫辛酸、辛伐他汀和别嘌醇。一些植物,如夹竹桃科、唇形科和茜草科植物,似乎在治疗这类蛇毒中毒方面具有有益作用。未来的研究肯定会找到治疗蛇咬伤事故的新治疗措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49e3/4105065/4e74eb0cfcf6/0036-4665-rimtsp-55-05-295-gf01.jpg

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