Biology Department, Jordan University for Science and Technology, Irbid, Jordan.
Department of Biological Sciences, The University of Jordan, Amman, Jordan.
Toxicon. 2021 Feb;191:83-103. doi: 10.1016/j.toxicon.2020.12.017. Epub 2020 Dec 31.
The twelve Arab countries of the Middle East are inhabited by 117 species of scorpions of varying medical importance within six families. Scorpion stings are a very common occurrence throughout the region. Twenty-two scorpion species are considered to be dangerously venomous, causing potentially life threatening stings. Accessible literature in English and Arabic on scorpions, scorpion stings and available antivenoms was reviewed to document the scorpion fauna and scorpion stings in each country. Saudi Arabia, Iraq and Jordan report the highest numbers of stings and envenomings. Clinically, the most important toxins in Old World scorpion venoms are α-toxins that target voltage-gated sodium (Na) channels at neurotoxin binding site 3, causing sympathetic excitation and the endogenous release of catecholamines that is responsible for transient, but life-threatening myocardial damage. Most victims of scorpion stings suffer severe local pain, but a few, especially children, develop systemic envenoming which, in the case of most Middle Eastern buthid species, such as Androctonus and Leiurus species, is dominated by the cardiovascular and respiratory consequences of hypercatecholinaemic myocarditis. Other syndromes include paralysis (Parabuthus leiosoma), coagulopathy (Nebo hierichonticus and Hemiscorpius species), and local tissue damage, haemolysis and acute kidney injury (H. lepturus). Early antivenom treatment is recommended but its value remains controversial. However, intensive care, with the ancillary use of vasoactive drugs such as prazosin and dobutamine, has proved effective.
中东的 12 个阿拉伯国家共有 6 科 117 种具有不同医学重要性的蝎子。在该地区，蝎子蜇伤非常常见。有 22 种蝎子被认为是剧毒的，可能会导致危及生命的蜇伤。本文查阅了有关蝎子、蝎子蜇伤和可用抗蛇毒血清的英文和阿拉伯文文献，以记录每个国家的蝎子区系和蝎子蜇伤情况。沙特阿拉伯、伊拉克和约旦报告的蜇伤和中毒人数最多。在临床上，旧世界蝎子毒液中最重要的毒素是α-毒素，它靶向电压门控钠（Na）通道上的神经毒素结合位点 3，导致交感神经兴奋和儿茶酚胺的内源性释放，从而导致短暂但危及生命的心肌损伤。大多数蝎子蜇伤患者会出现严重的局部疼痛，但少数患者，尤其是儿童，会出现全身性中毒，在大多数中东 Buthidae 物种（如 Androctonus 和 Leiurus 物种）中，这种中毒主要表现为高儿茶酚胺性心肌炎的心血管和呼吸系统后果。其他综合征包括瘫痪（Parabuthus leiosoma）、凝血功能障碍（Nebo hierichonticus 和 Hemiscorpius 物种）以及局部组织损伤、溶血和急性肾损伤（H. lepturus）。建议早期使用抗蛇毒血清治疗，但其价值仍存在争议。然而，重症监护并辅助使用血管活性药物（如哌唑嗪和多巴酚丁胺）已被证明是有效的。
