神经精神型有毒蘑菇及其毒素研究进展  

Research progress on neuropsychiatric poisonous mushrooms and their toxins

作　　者：代软仙 孟强 陈国兵 DAI Ruanxian;MENG Qiang;CHEN Guobing(Department of Neurology,Affiliated Hospital of Kunming University of Science and Technology,The First People's Hospital of Yunnan Province.No.157 Jinbi Road,Xishan District,Kunming 650032,China)

机构地区：[1]昆明理工大学生命科学与技术学院昆明理工大学附属医院,云南650023 [2]昆明理工大学附属医院,云南省第一人民医院神经内科 [3]昆明理工大学附属医院,云南省第一人民医院急诊内科

出　　处：《中国神经精神疾病杂志》2022年第8期493-497,共5页Chinese Journal of Nervous and Mental Diseases

基　　金：云南省高层次人才健康培训项目(编号:L-2017013);云南省万人计划-名医项目(编号:YNWR-MY-2018-018)。

摘　　要：食用野生蘑菇日益流行导致蘑菇中毒事件的发生率不断增加。近年来,随着我国对蘑菇中毒事件广泛深入的调查,发现蘑菇中毒中导致神经精神型的事件越来越多。目前已经发现的有毒蘑菇中可导致神经中毒的毒素主要为毒蕈碱、异噁唑衍生物、裸盖菇素及鹿花菌素;该型蘑菇中毒不仅临床表现复杂多样,其毒理机制也比较复杂。目前国内对于该类中毒的毒理学机制研究较少,相关毒素尚未得到充分的研究。本文就神经精神型有毒蘑菇的种类、毒素分类、临床表现及中毒机理、诊断、治疗方面进行综述,发现导致神经精神型中毒的有毒蘑菇主要是鹅膏菌属、裸盖伞属及牛肝菌属类,临床表现依据蘑菇不同种类可表现不同的症状,目前尚无特效解毒剂,治疗以对症支持为主,大多数情况下,预后良好。此类毒蘑菇与食用菌的外观特征不明显,容易误食,亟需加强识别,并加强此类毒蘑菇毒素的致病机理研究,为该类毒蘑菇中毒的治疗提供基础数据与科学指导。本文还对目前研究热点与未来研究重点进行了展望。The increasing popularity of wild mushroom consumption has increased the incidence of mushroom poisoning.In recent years,with the extensive in-depth investigation of mushroom poisoning incidents in China,the numbers of incidents of mushroom poisoning leading to neuropsychiatric type have dramatically increased.Currently,the toxins that can lead to neurotoxicity in toxic mushrooms are mainly muscarinic,isoxazole derivatives,psilocybin,and gyromitrin;this type of mushroom poisoning not only causes complex and diverse in clinical manifestations but also has a complex toxicological mechanism.In this paper,we review the relevant literature with focus on the types of neuropsychiatric poisonous mushrooms,toxin classification,clinical manifestations,and poisoning mechanism,diagnosis,and treatment.Majority of toxic mushrooms leading to neuropsychiatric type poisoning are the Amanita,Psilocybe,and Boletus species.Clinical manifestations can vary according to different species of mushrooms.There is no specific antidote and treatment for mushroom poisoning.Treatments mainly rely on symptomatic support.The prognosis is good in most cases.However,there are no distinguishing macroscopic characteristics between these poisonous mushrooms and edible mushrooms.Therefore,they are easy to be eaten accidentally.Hence,it is urgent to strengthen the identification and research on the pathogenic mechanism of these poisonous mushroom toxins to provide essential data and scientific guidance for treating this type of toxic mushroom poisoning.This paper also provides an outlook on the current research hotspots and future research priorities.

关 键 词：神经精神型 毒蘑菇 毒素 神经毒素 毒蕈碱 异噁唑衍生物 裸盖菇素 

分 类 号：R749.6[医药卫生—神经病学与精神病学]