暴发性雪卡毒素中毒59例  

Outbreak of ciguatoxin poisoning in 59 patients

作　　者：廖清高[1] 隋敏生[1] 陈纪平[1] 

机构地区：[1]汕头市中心医院急诊科,广东省汕头515031

出　　处：《中华急诊医学杂志》2005年第8期663-666,共4页Chinese Journal of Emergency Medicine

摘　　要：目的探讨雪卡毒素中毒的临床特征.方法对一起进食'老虎斑'致59人雪卡毒素中毒事件进行临床回顾性描述,并结合文献进行分析.结果雪卡毒素广泛存在热带、亚热带珊瑚礁鱼中,其中石斑鱼最常见,是鱼类通过食物链获得.中毒人群男性占76.27%,30～49岁占50.85%,中毒后0.5～16 h出现症状,有头晕、乏力、腹痛腹泻(93.22%),恶心呕吐(84.74%),心悸胸闷(49.15%),低血压(＜90/60 mmHg,44.07%,心率减慢(＜60次/min,49.15%);2～3 d感觉异常(62.71%),持续2～5周;其中温度感觉倒错(55.93%),持续2～3周.饮酒者出现低血压、心率减慢、感觉异常比无饮酒者更明显(P＜0.01).结论雪卡毒素中毒可造成胃肠功能紊乱、心血管功能障碍、持续长时间的神经感觉异常,并且以温度感觉倒错最具特征性;饮酒可加重病情,预后良好.为避免中毒,建议勿食用重1.5 kg以上的珊瑚礁鱼,特别是其头和内脏.Objective To investigate clinical characteristics of ciguatoxin poisoning. Methods Fifty-nine patients with ciguatoxin poisoning were analyzed by retrospectively. Results Ciguatoxin generally exists in the reef fishes in tropical and subtropical zones, more common in cabrilla, which is produced by dinoflagellatealgae （gambierdiscus toxicus） andpassed up the food chain. In the 59 patients poisoned by ciguatoxin, 76.27% were male, 50.85% aged 30 to 40 yearsold. Symptoms usually started 0.5 to 16 hours after eating the poisonous fish, symptoms included Dizziness, debility,abdominal pain and diarrhea accounted for 93.22%, nausea and vomiting accounted for 84.74%, palpitation and chest discountort in 49.15% o hypotension （blood pressure 〈 90/60 mmHg） in 44.07%, decreased heart rate （heart rate 〈60/min） diseountort in 49.15%. 62.71% patients with paraesthesia lasted for 2 - 5 weeks, 55.93% of there was paraesthesiae appeared temperature paralgesia lasting for 2 to 3 weeks. The prevalence of hypotension, decreased heart rate and paraesthesia was more common in the alcohol users than in the non-alcohol users （ P 〈 0.01 ）. Conclusion Ciguatoxin poisoning could lead to gastrointestinal dysfunction, cardiovascular impairment and persistent paraesthesia with characteristic temperature paralgesia. Drinking alcohol would aggravate the patients＇ condition, but the prognosis is optimistic. To prevent from ciguatoxin poisoning, it suggestes not to eat reef fish, especially the head and the internal organs.

关 键 词：暴发性 雪卡毒素中毒 心率 心血管功能 CTX 

分 类 号：R595[医药卫生—内科学]