Cole H P, Wesley R E, King L E
Southeastern Oculoplastic Center, Atlanta, Georgia 30309, USA.
Ophthalmic Plast Reconstr Surg. 1995 Sep;11(3):153-64. doi: 10.1097/00002341-199509000-00001.
The authors developed a rabbit model of the brown recluse (BR) spider envenomation of the human eyelid. The spider bite causes cutaneous necrosis and systemic toxicity in human eyelids, possibly leading to disseminated intravascular coagulation, hemolysis, and death. The treatment has been controversial. The animal model evaluated the effects of single- and combined-agent therapy in four phases: venom dose response, time course, therapeutic effectiveness (steroid vs. dapsone vs. antivenom), and optimal therapy (steroid and dapsone; steroid and antivenom; and dapsone and antivenom combination groups). The combination dapsone and antivenom treatment group was the optimal animal regimen, although not completely effective in eliminating microscopic necrosis. The authors also report dramatic clinical improvement in human inflammatory response with dapsone therapy and recommend immediate dapsone therapy combined with specific BR venom, if available, in humans.
作者建立了棕色隐遁蛛（BR）叮咬人眼睑的兔模型。蜘蛛叮咬会导致人眼睑皮肤坏死和全身毒性，可能引发弥散性血管内凝血、溶血甚至死亡。其治疗方法一直存在争议。该动物模型分四个阶段评估了单药治疗和联合治疗的效果：毒液剂量反应、时间进程、治疗效果（类固醇与氨苯砜与抗蛇毒血清）以及最佳治疗方案（类固醇与氨苯砜；类固醇与抗蛇毒血清；氨苯砜与抗蛇毒血清联合组）。氨苯砜与抗蛇毒血清联合治疗组是最佳动物治疗方案，尽管在消除微观坏死方面并不完全有效。作者还报告称，氨苯砜治疗可使人体炎症反应显著改善，并建议在人类中立即采用氨苯砜治疗，如有可用的特定BR毒液则联合使用。
