Chippaux J-P, Baldé M C, Sessinou É, Yéro Boiro M, Massougbodji A
UMR 216, Institut de recherche pour le développement, Santé de la mère et de l'enfant, 08 BP 841, Cotonou, Bénin, Université Paris Descartes, Sorbonne Paris Cité, 4 avenue de l'Observatoire, 75006 Paris, France.
Institut Pasteur de Guinée, Kindia, Guinea.
Med Sante Trop. 2015 Jan-Mar;25(1):56-64. doi: 10.1684/mst.2014.0413.
The authors evaluated the safety and efficacy of Inoserp(®) Pan Africa, a new polyvalent antivenom composed of highly purified and lyophilized fragments of F(ab')2 immunoglobulins, recently registered in Benin and Guinea.
We treated 100 patients in northern Benin (Atacora) and 109 in Maritime Guinea (Kindia) with confirmed envenomation. Treatment consisted of intravenous administration of 1 vial for uncomplicated envenomation, and 2 vials for hemorrhagic or neurotoxic envenomation. The dose was repeated when bleeding or signs of neurotoxicity persisted or appeared.
In Atacora, on arrival at the hospital, 90% of patients had incoagulable blood, and 50% were bleeding. The resolution of these bleeding disorders was obtained in less than 3 hours for 50% of the patients and in less than 24 hours for 98%. Four patients died. In Kindia, 96 patients (88%) presented viper bites with pain + edema and 13 (12 %) others showed elapid (ptosis, dyspnea) envenomation. One patient bitten by a member of the Elapidae family, died despite early treatment. In Benin, protocol deviations for 60% of patients led to significant underdosing of the antivenom; the proportion was much lower (2%) in Guinea. Signs of intolerance after Inoserp(®) Pan Africa administration were reported in 8% of patients. All these symptoms were mild and disappeared rapidly after an antihistamine or corticosteroid treatment.
Treatment using intravenous Inoserp(®) Pan Africa appeared to be well tolerated and effective against snakebite envenomation in both epidemiological settings.
作者评估了Inoserp(®) Pan Africa的安全性和有效性，这是一种新的多价抗蛇毒血清，由高度纯化和冻干的F(ab')2免疫球蛋白片段组成，最近在贝宁和几内亚注册。
我们对贝宁北部（阿塔科拉）的100名患者和几内亚滨海区（金迪亚）的109名确诊中毒患者进行了治疗。治疗方法为静脉注射，无并发症中毒注射1瓶，出血性或神经毒性中毒注射2瓶。当出血或神经毒性症状持续或出现时重复给药。
在阿塔科拉，患者入院时，90%的患者血液无法凝固，50%的患者有出血症状。50%的患者在不到3小时内出血症状得到缓解，98%的患者在不到24小时内得到缓解。4名患者死亡。在金迪亚，96名患者（88%）被蝰蛇咬伤，伴有疼痛和水肿，另外13名患者（12%）表现为眼镜蛇科（上睑下垂、呼吸困难）中毒。一名被眼镜蛇科蛇咬伤的患者尽管接受了早期治疗仍死亡。在贝宁，60%的患者治疗方案偏差导致抗蛇毒血清剂量严重不足；在几内亚这一比例要低得多（2%）。8%的患者报告了注射Inoserp(®) Pan Africa后出现不耐受症状。所有这些症状都很轻微，在使用抗组胺药或皮质类固醇治疗后迅速消失。
在这两种流行病学环境中，静脉注射Inoserp(®) Pan Africa进行治疗似乎耐受性良好，对蛇咬伤中毒有效。
