Rafati-Rahimzadeh Mehrdad, Rafati-Rahimzadeh Mehravar, Kazemi Sohrab, Jafarian Amiri Seyedeh Roghieh, Soleymani Abbas, Moghadamnia Ali Akbar
Department of Nursing, Babol University of Medical Sciences, Babol, Iran.
Neuroscience Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
Caspian J Intern Med. 2022 Summer;13(3):458-468. doi: 10.22088/cjim.13.3.458.
Amongst the chemical warfare agents, blistering (vesicant) agents can be significant materials. The most important agent in this group is sulfur mustard (mustard gas) which is known as "King of chemical warfare (CW) agents ". Exposure to this agent, seriously causes damages in several organs, such as the eyes. This article reviews the ophthalmological aspects of sulfur mustard with reference of its management.
A wide-ranging search in PubMed databases, Thomson Reuters and Scopus was done and different aspects of chemical properties of sulfur mustard, its mechanism of action and effects on eyes, clinical finding, diagnostic evaluation, initiate actions, pharmaceutical and surgical interventions was reported.
Sulfur mustard can alkylate DNA and RNA strands and break down structures of protein and lipid of cell membrane. This may impair cell energy production, and leads to cell death. Exposure to sulfur mustard, therefore, causes such problems for organs, including irreversible damage to the eyes.
Understanding the mechanism of the sulfur mustard effect and the early training in prevention injuries will cause fewer complications and damage to organs, including the eyes. Washing the eyes with tap water or eyewash solutions, using mydriatic drops, anti- inflammatory drugs, matrix metalloproteinase inhibitors and antibiotics may help to the management of poisoning. Surgical interventions including tarsorrhaphy, amniotic membrane transplantation, stem cell transplantation and corneal transplantation could reduce the harm to the victims.
在化学战剂中，起泡（糜烂性）剂可能是重要的物质。该类中最重要的制剂是硫芥（芥子气），它被誉为“化学战剂之王”。接触这种制剂会严重损害多个器官，如眼睛。本文参考硫芥的治疗方法，综述其眼科方面的情况。
在PubMed数据库、汤森路透和Scopus中进行了广泛检索，并报告了硫芥的化学性质、作用机制、对眼睛的影响、临床发现、诊断评估、初始措施、药物和手术干预等不同方面。
硫芥可使DNA和RNA链烷基化，并破坏细胞膜的蛋白质和脂质结构。这可能会损害细胞能量产生，并导致细胞死亡。因此，接触硫芥会给包括眼睛在内的器官带来此类问题，包括不可逆转的损伤。
了解硫芥作用机制并尽早进行预防损伤培训，将减少包括眼睛在内的器官并发症和损伤。用自来水或洗眼液冲洗眼睛、使用散瞳滴眼液、抗炎药物、基质金属蛋白酶抑制剂和抗生素可能有助于中毒的治疗。包括睑裂缝合术、羊膜移植、干细胞移植和角膜移植在内的手术干预可以减轻对受害者的伤害。
