Chen Xinguo, Wu Ruike, Jin Huanzhi, Gao Renxian, Yang Baohua, Wang Qian
Department of Emergency Medicine, Wenzhou People's Hospital, China.
J Nippon Med Sch. 2015;82(5):257-61. doi: 10.1272/jnms.82.257.
Aconitine is a highly toxic diterpenoid alkaloid, produced by plants of the Aconitum genus, that is still used in Chinese herbal medicines. Aconitine poisoning remains common in China and other parts of Asia.
A 48-year-old man received a diagnosis of aconitine poisoning after ingesting herbal medicinal wine made with caowu, which is made from Aconitum kusnezoffii roots, and was admitted to our hospital' s emergency department. Electrocardiography and thoracoabdominal computed tomography showed cardiovascular toxicity from aconitine poisoning along with polycystic renal hemorrhaging. Because the arrhythmia was not controlled with lidocaine, blood purification with a reduced dosage of heparin was performed to treat the arrhythmia and to avoid increasing the bleeding of the polycystic renal hemorrhage. The patient recovered from aconitine poisoning and polycystic kidney hemorrhage.
This case significantly advances our understanding of hemoperfusion with reduced heparin for the treatment of ventricular arrhythmia caused by aconitine poisoning.
乌头碱是一种剧毒的二萜生物碱，由乌头属植物产生，仍用于中草药中。在中国和亚洲其他地区，乌头碱中毒仍然很常见。
一名48岁男性在饮用了用草乌（由北乌头根部制成）泡制的草药酒后，被诊断为乌头碱中毒，并被收入我院急诊科。心电图和胸腹部计算机断层扫描显示，乌头碱中毒导致心血管毒性，同时伴有多囊肾出血。由于利多卡因未能控制心律失常，因此采用减少肝素剂量的血液净化方法来治疗心律失常，并避免加重多囊肾出血的出血情况。患者从乌头碱中毒和多囊肾出血中康复。
该病例显著增进了我们对减少肝素血液灌流治疗乌头碱中毒所致室性心律失常的理解。
