Krenzelok E P, Jacobsen T D, Aronis J
Pittsburgh Poison Center, Children's Hospital of Pittsburgh, University of Pittsburgh, Pennsylvania, USA.
J Toxicol Clin Toxicol. 1998;36(3):219-23. doi: 10.3109/15563659809028942.
Taxus species, commonly referred to as yew plants, have the reputation of being inordinately toxic. Case reports which chronicle human near-fatal yew berry ingestions and countless fatalities in livestock present a sober profile to the treating toxicologist. Very often, a limited number of adverse reports influence decisions on all exposures to that potential poison. The objective of this investigation was to profile the toxicity of exposures to Taxus spp and determine what percentage of exposures were associated with significant morbidity.
The individual computerized files of all exposures to Taxus spp were retrieved from American Association of Poison Control Centers (AAPCC) Toxic Exposure Surveillance System (TESS) and placed in a relational database. Reports from 1985-1994 were analyzed. The cases were examined to determine patient demographics, the outcome of exposures, the ultimate disposition of the patients, treatment, and symptoms. AAPCC TESS definitions were used to assess outcomes.
The number of exposures identified from the 10-year subset was 11,197. Children less than 12 years of age were involved in 96.4% (< 6 years 92.7%; 6-12 years, 3.7%) of the exposures. When the final outcome of the exposure was documented (n = 7269), no adverse effects occurred in 92.5% and minor effects were experienced in 7.0%. Moderate (more pronounced, but not life-threatening) effects were experienced by 30 individuals and major (life-threatening) effects occurred in 4 people. There were no fatalities. Decontamination therapy, when compared to no therapy, had no impact on patient outcome. 6.3% were admitted for psychiatric or medical care. When symptoms were related to Taxus spp exposures, the most frequent symptoms were gastrointestinal (65.5%), followed by dermal (8.3%), neurological (6.0%), and cardiovascular (6.0%).
There are limitations to the interpretation of AAPCC TESS data which may lead to bias in favor of positive outcomes. However, the large sample size may minimize the limitations.
Taxus spp exposures result only rarely in significant morbidity. Consistent with published case reports, the most common symptoms were gastrointestinal. Decontamination had no impact on patient outcome.
红豆杉属植物，通常被称为紫杉，有剧毒的名声。记录人类因误食紫杉浆果而险些致命以及家畜大量死亡的病例报告，为治疗毒理学家呈现了严峻的情况。很多时候，数量有限的不良报告影响着对所有接触该潜在毒物情况的决策。本调查的目的是剖析接触红豆杉属植物的毒性，并确定有显著发病率的接触占比。
从美国毒物控制中心协会（AAPCC）的毒物接触监测系统（TESS）中检索出所有接触红豆杉属植物的个人电脑记录，并录入关系数据库。对1985 - 1994年的报告进行分析。检查病例以确定患者人口统计学信息、接触结果、患者最终处置情况、治疗方法及症状。采用AAPCC TESS的定义来评估结果。
从10年的子集里确定的接触病例数为11197例。12岁以下儿童占接触病例的96.4%（小于6岁的占92.7%；6 - 12岁的占3.7%）。当记录了接触的最终结果时（n = 7269），92.5%未出现不良反应，7.0%有轻微影响。30人有中度（更明显但无生命危险）影响，4人有重度（危及生命）影响。无死亡病例。与未进行治疗相比，去污疗法对患者结局无影响。6.3%因精神或医疗护理入院。当症状与接触红豆杉属植物有关时，最常见的症状是胃肠道症状（65.5%），其次是皮肤症状（8.3%）、神经症状（6.0%）和心血管症状（6.0%）。
对AAPCC TESS数据的解读存在局限性，这可能导致偏向积极结果的偏差。然而，大样本量可能会使这些局限性最小化。
接触红豆杉属植物极少导致显著发病。与已发表的病例报告一致，最常见的症状是胃肠道症状。去污对患者结局无影响。
