自泡中药酒甲醇超标导致中毒性视神经病变2例并文献复习  

Two cases of toxic optic neuropathy caused by methanol exceeding standard in self-brewed Chinese medicinal wine and review of relevant literature

作　　者：李亚 赵伟 宋玉倩 张铭连 石慧君 LI Ya;ZHAO Wei;SONG Yuqian;ZHANG Minglian;SHI Huijun(Hebei Eye Hospital,Hebei Provincial Key Laboratory of Ophthalmology,Hebei Institute of Ophthalmology,Hebei,Xingtai 054001,China;980th Hospital of PLA Joint Logistic Support Force,Hebei,Shijiazhuang 050000,China)

机构地区：[1]河北省眼科医院河北省眼科学重点实验室河北省眼科研究所,河北邢台054001 [2]解放军联勤保障部队第九八〇医院,河北石家庄050000

出　　处：《中国医药科学》2023年第14期183-186,共4页China Medicine And Pharmacy

基　　金：河北省名中医传承工作室建设项目(冀中医药函〔2018〕47号)。

摘　　要：中毒性视神经病变指外来药物或毒物使视神经纤维受累而引起视功能障碍的疾病,亦称中毒性弱视。临床上引起中毒的可见烟草、甲醇、乙醇、铅、铊、汞、乙胺丁醇、有机磷农药、奎宁等。此类病变常累及视盘黄斑束,表现为中心暗点型视野损害;奎宁中毒常累及视网膜神经节细胞和视神经纤维,表现为周边视野缩小型视野损害。因饮用甲醇而致急性中毒的事件时有发生,常起病急、预后差,多造成不可逆性视功能损害,危及人们的健康和生命安全。而因饮用中药酒造成视神经损害的报道罕见,本文报道2例因饮用相同自泡中药酒后发生中毒性视神经病变的病例。本文通过报道患者的眼部表现、诊疗过程,回顾复习相关文献,总结甲醇中毒的眼部发病机制、临床表现、治疗方法和预后,以期进一步提高临床医生的诊疗水平,最大程度保障广大群众的生命安全和挽救视功能。Toxic optic neuropathy(TON)refers to visual dysfunction caused by foreign drugs or poisons that damage the optic nerve fibers,also known as toxic amblyopia.Clinical causes include tobacco,methanol,ethanol,lead,thallium,mercury,ethambutol,organophosphorus pesticides and quinine.This disease often affects the macula lutea of the optic disc and presents as visual field damage to the central dark spot.Quinine poisoning often affects the retinal ganglion cells and optic nerve fibers and presents as peripheral visual field narrowing.Acute methanol poisoning occurs occasionally and often has a rapid onset and poor prognosis,causing irreversible damage to visual function and endangering people’s health and life.However,there are rare reports on optic nerve damage caused by the consumption of Chinese medicinal wine,and this paper reports two cases of TON caused by the consumption of the same self-brewed Chinese medicinal wine.The report includes the ocular manifestations,and diagnosis and treatment processes of these two patients.Combined with relevant literature and summary of ocular pathogenesis,clinical manifestations,and treatment and prognosis of methanol poisoning,this paper aims to further improve the diagnosis and treatment level of clinicians and better protect the safety and life and save the visual function of the general public.

关 键 词：中药酒 甲醇中毒 视神经损害 临床表现 治疗预后 

分 类 号：R774.6[医药卫生—眼科]