Instituto Clodomiro Picado, Facultad de Microbiología, Universidad de Costa Rica, PO Box 11501-2060, San José, Costa Rica.
Instituto de Biomedicina de Valencia, Consejo Superior de Investigaciones Científicas (CSIC), Valencia, Spain.
Nat Rev Dis Primers. 2017 Sep 14;3:17063. doi: 10.1038/nrdp.2017.63.
Snakebite envenoming is a neglected tropical disease that kills >100,000 people and maims >400,000 people every year. Impoverished populations living in the rural tropics are particularly vulnerable; snakebite envenoming perpetuates the cycle of poverty. Snake venoms are complex mixtures of proteins that exert a wide range of toxic actions. The high variability in snake venom composition is responsible for the various clinical manifestations in envenomings, ranging from local tissue damage to potentially life-threatening systemic effects. Intravenous administration of antivenom is the only specific treatment to counteract envenoming. Analgesics, ventilator support, fluid therapy, haemodialysis and antibiotic therapy are also used. Novel therapeutic alternatives based on recombinant antibody technologies and new toxin inhibitors are being explored. Confronting snakebite envenoming at a global level demands the implementation of an integrated intervention strategy involving the WHO, the research community, antivenom manufacturers, regulatory agencies, national and regional health authorities, professional health organizations, international funding agencies, advocacy groups and civil society institutions.
蛇伤中毒是一种被忽视的热带病，每年导致超过 10 万人死亡，40 多万人致残。生活在农村热带地区的贫困人群尤其容易受到伤害；蛇伤中毒使贫困循环持续下去。蛇毒是一种复杂的蛋白质混合物，具有广泛的毒性作用。蛇毒成分的高度变异性导致了中毒的各种临床表现，从局部组织损伤到潜在的危及生命的全身影响。静脉注射抗蛇毒血清是对抗中毒的唯一特效治疗方法。还使用了镇痛药、呼吸机支持、液体疗法、血液透析和抗生素治疗。基于重组抗体技术和新型毒素抑制剂的新型治疗方法正在探索中。在全球范围内应对蛇伤中毒需要实施一项综合干预策略，涉及世界卫生组织、研究界、抗蛇毒血清制造商、监管机构、国家和地区卫生当局、专业卫生组织、国际供资机构、宣传团体和民间社会组织。
