蛇咬伤受害者早期（过敏样）抗蛇毒血清反应的预测、预防及机制
Prediction, prevention, and mechanism of early (anaphylactic) antivenom reactions in victims of snake bites.
作者信息
Malasit P, Warrell D A, Chanthavanich P, Viravan C, Mongkolsapaya J, Singhthong B, Supich C
出版信息
Br Med J (Clin Res Ed). 1986 Jan 4;292(6512):17-20. doi: 10.1136/bmj.292.6512.17.
Abstract
Victims of snake bites are often subjected to cutaneous or conjunctival hypersensitivity testing before being given antivenom. None of 12 early (anaphylactic) reactions was predicted by these tests in 25 Nigerian and Thai patients. The incidence and severity of early reactions was the same whether antivenom was given by intravenous injection over 10 minutes or diluted and given as an intravenous infusion over 30 minutes. Although antivenom activated complement in vitro, there was no evidence of complement activation or formation of immune complexes in patients bitten by snakes who were treated with antivenom, whether or not they developed early reactions. Higher doses of antivenom might induce the complement activation and formation of immune complexes (aggregates) that have been observed during the clinically more severe reactions associated with homologous immunoglobulin treatment.
摘要
在注射抗蛇毒血清之前，蛇咬伤受害者通常要进行皮肤或结膜过敏试验。在25名尼日利亚和泰国患者中，这些试验未能预测出12例早期（过敏）反应中的任何一例。无论抗蛇毒血清是在10分钟内静脉注射，还是稀释后在30分钟内静脉输注，早期反应的发生率和严重程度都是相同的。尽管抗蛇毒血清在体外能激活补体，但在接受抗蛇毒血清治疗的蛇咬伤患者中，无论是否出现早期反应，均无补体激活或免疫复合物形成的证据。更高剂量的抗蛇毒血清可能会诱导补体激活和免疫复合物（聚集体）的形成，这在与同源免疫球蛋白治疗相关的临床更严重反应中已有观察到。
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