Mosbech H
Allergy. 1983 Apr;38(3):195-200. doi: 10.1111/j.1398-9995.1983.tb01606.x.
During a 21-year period in Denmark a total of 26 deaths were caused by wasp or bee stings (according to the National Health Service). The deaths might be classified, with some overlapping, as caused by either anaphylactic/anaphylactoid shocks (between 65% and 80%), suffocation after stings in the airways (about 15%) or preexisting diseases, especially arteriosclerotic heart disease (approx. 20%). Characteristically, in most persons with shock reactions unconsciousness and death occurred very shortly after the sting (within 45 min), while the interval between sting and death was longer (30 min to a couple of hours) when death was caused by suffocation. In more than 21 of the 26 cases it seemed reasonable to assume that insect allergy might have contributed to the fatal outcome. Six of these cases had a previous history of abnormal reactions to insect venom, thus only a small group would have benefited from the prophylactic effect of hyposensitisation. There was no known previous history of reactions to insect stings in the other cases, but it is likely that more than six persons had had severe reactions to insect stings on other occasions. Presumably many deaths where insect stings have been involved--through not verified as causal--are classified as inexplicable or accidental, thus the real number of deaths caused by wasp or bee stings could be substantially greater. Consequently hyposensitisation after severe insect sting reactions of verified allergic genesis can still be advised.
在丹麦的21年期间，据国家医疗服务机构统计，黄蜂或蜜蜂蜇伤共导致26人死亡。这些死亡可作如下分类（存在一定重叠）：过敏性/类过敏性休克所致（65%至80%）、气道蜇伤后窒息所致（约15%）或原有疾病所致，尤其是动脉硬化性心脏病（约20%）。其特点是，大多数发生休克反应的人在蜇伤后很快（45分钟内）就会失去意识并死亡，而因窒息导致死亡时，蜇伤与死亡之间的间隔时间较长（30分钟至数小时）。在26例病例中，超过21例似乎有理由认为昆虫过敏可能导致了致命后果。其中6例有昆虫毒液异常反应的既往史，因此只有一小部分人能从脱敏预防效果中获益。其他病例没有已知的昆虫蜇伤反应既往史，但很可能有超过6人在其他场合对昆虫蜇伤有过严重反应。据推测，许多涉及昆虫蜇伤的死亡——尽管未被证实为因果关系——被归类为不明原因或意外，因此黄蜂或蜜蜂蜇伤导致的实际死亡人数可能要多得多。因此，对于已证实为过敏性起源的严重昆虫蜇伤反应后，仍可建议进行脱敏治疗。
