郴州市一起灰花纹鹅膏中毒事件调查与分析  

Investigation and analysis of a poisoning incident caused by Amanita fuliginea in Chenzhou

作　　者：刘勋[1] 周亮[1] 邱彬[1] 曹永平 罗睿 廖斌 欧社祥[1] LIU Xun;ZHOU Liang;QIU Bin;CAO Yongping;LUO Rui;LIAO Bin;OU Shexiang(Chenzhou Center for Disease Control and Prevention,Hunan Chenzhou 423000,China;Yongxing Center for Disease Control and Prevention,Hunan Yongxing 423300,China;Suxian Center for Disease Control and Prevention,Hunan Suxian 423000,China)

机构地区：[1]郴州市疾病预防控制中心,湖南郴州423000 [2]永兴县疾病预防控制中心,湖南永兴423300 [3]苏仙区疾病预防控制中心,湖南苏仙423000

出　　处：《中国食品卫生杂志》2021年第5期623-627,共5页Chinese Journal of Food Hygiene

基　　金：郴州市科技局项目(ZDYF201978,ZDYF2020198)。

摘　　要：目的调查2020年6月湖南省郴州市发生的一起毒蘑菇中毒事件,分析事件发生的原因,为制定防控措施提供依据。方法对中毒原因开展流行病学调查,采集可疑毒蘑菇样品并进行形态学鉴定,同时应用液质联用法测定蘑菇样品和患者血液中的蘑菇毒素。结果本次毒蘑菇中毒事件发病7人,死亡1人;患者均进食了自行采摘的野生蘑菇,潜伏期14~23 h,早期临床表现为呕吐、腹痛、腹泻等胃肠道症状,进而出现进行性肝损害,严重者因急性肝衰竭而死亡;患者血液生化检测丙氨酸氨基转移酶、门冬氨酸氨基转移酶、乳酸脱氢酶异常升高;采集现场剩余可疑毒蘑菇样品,经外观形态学鉴定和蘑菇毒素检测,综合鉴定为灰花纹鹅膏。结论本次事件是因误采误食灰花纹鹅膏引起的中毒事件,建议加大毒蘑菇中毒宣传力度,建立蘑菇毒素快速筛查技术,完善食源性疾病监测网络,以减少毒蘑菇中毒和死亡的发生。Objective To investigate an incident of mushroom poisoning in Chenzhou,Hunan province in June 2020,analyze the cause of the incident,and provide a basis for formulating prevention and control measures.Methods Epidemiological investigation was carried out to find the cause of poisoning.The samples of suspicious poisonous mushroom were collected for morphological identification,and the mushroom toxin and blood samples were determined by LC-MS.Results There were 7 cases of mushroom poisoning and 1 death.All the patients ate wild mushrooms picked up by themselves,and the incubation period was 14-23 h.Early clinical manifestations included vomiting,abdominal pain,diarrhea and other gastrointestinal symptoms,which led to progressive liver damage and death in severe cases due to acute liver failure.Blood biochemistry showed abnormal elevation of alanine aminotransferase,aspartate aminotransferase and lactate dehydrogenase.The remaining wild mushrooms collected on site were identified as Amanita fuliginea by morphological identification and mushroom toxin test.Conclusion This was a mushroom poisoning incident caused by the accidental ingestion of highly toxic Amanita fuliginea.Publicity on mushroom poisoning should be strengthened.Rapid screening technique of mushroom toxin and Foodborne Disease Surveillance Network should be improved to reduce the incidence of mushroom poisoning and death.

关 键 词：毒蘑菇 灰花纹鹅膏 食物中毒 鹅膏毒素检测 

分 类 号：R155[医药卫生—营养与食品卫生学]