George A, Tharakan V T, Solez K
Department of Nephrology, Caritas Hospital, Kottayam, Kerala, India.
Ren Fail. 1987;10(2):91-9. doi: 10.3109/08860228709056322.
Viper bites are a significant cause of mortality in India. Acute renal failure is a common finding in cases of lethal envenomization. Coagulation abnormalities and shock are other key clinical features. Some of the renal lesions appear to reflect a direct toxic effect of venom on kidney parenchyma. Glomerular, tubular, interstitial, and vascular lesions have all been described. Experimentally, viper venom causes mesangiolysis, and this may be a significant factor in the pathogenesis of viper bite-induced glomerular disease. Treatment with antivenom is commonly used but is not supported by controlled trials. Dialysis and supportive treatment appear to be the mainstay of therapy in cases complicated by renal failure.
在印度，蝰蛇咬伤是导致死亡的一个重要原因。急性肾衰竭是致命性蛇毒中毒病例的常见表现。凝血异常和休克是其他关键的临床特征。一些肾脏病变似乎反映了蛇毒对肾实质的直接毒性作用。肾小球、肾小管、间质和血管病变均有描述。在实验中，蝰蛇毒可导致肾小球系膜溶解，这可能是蝰蛇咬伤所致肾小球疾病发病机制中的一个重要因素。抗蛇毒血清治疗是常用的，但缺乏对照试验的支持。在并发肾衰竭的病例中，透析和支持治疗似乎是主要的治疗方法。
