急型克山病患者暴死原因的假设  

A hypothesis for the pathogenesis of sudden death in patients of acute type Keshan disease

作　　者：杨进生[1,2] 张理汉[1,2] 朱杰荣 

机构地区：[1]军事医学科学院毒物药物研究所 [2]成都军区昆明军事医学研究所

出　　处：《中国地方病学杂志》1999年第3期176-179,共4页Chinese Jouranl of Endemiology

摘　　要：目的为探索急型克山病患者在较同步的短时间内暴死原因，拟提出一个假设，为科学研究建议一个方向。方法采用文献调查的方法，了解急型克山病患者暴死前重要的症状、体征，并与动物Ｔ－２毒素急性中毒实验中所出现的症状、体征进行比较。结果文献调查发现：１．急型克山病患者会在一个比较同步的短时间内发生暴死；２．患者死亡前有严重的呕吐，甚至混有胆汁；３．患者极度干渴，索饮大量凉水；４．出现一系列休克体征，如：血压进行性下降甚至到零，脉搏微弱、快速，直到扪不到。而这些症状在动物急性镰刀菌毒素中毒致死过程中亦是常见的，二者非常类似。结论急型克山病患者暴死的原因很可能是摄入霉变粮食中镰刀菌毒素急性中毒后。Objective In order to explore the pathogenesis of the sudden deaths in patients of acute type Keshan disease,the authors try to suggest a hypothesis for providing a direction in scientific research.Methods Surveying literatures,to find the important symptoms and signs before deaths occurred in patients of acute type Keshan disease,and compared with those occurred in acute intoxications of T 2 toxin in animal experiments.Results From the literatures survey,the most important symptoms and signs were found:1.sudden death occurred within a relative short synchronous time;2.severe vomiting,even mixed with bile;3.severe dry thirsty,asking for a large amount of cool drinking;4.a series of shock syndrome,as progressive lowering of blood pressure even to zero,and feeble,fast pulses to no pulse,and those were also usually occurred after acute intoxication of mycotoxins in animal experiments.Both were quite similar.Conclusions The pathogenesis of sudden death in patients of acute type Keshan disease might be due to the hypovolumic shock following the loss of body fluid after acute Fusarium mycotoxicosis from mouldy grain.

关 键 词：克山病 镰刀菌毒素 病因学 休克 

分 类 号：R542.302[医药卫生—心血管疾病]