急性亚稀褶红菇中毒的临床特征分析  

Clinical characteristics analysis of acute Russula subnigricans Hongo poisoning

作　　者：李娅[1] 符阳山 段红丹 刘林[1] 徐军[2] 郑粉双 Li Ya;Fu Yangshan;Duan Hongdan;Liu Lin;Xu Jun;Zheng Fenshuang(Emergency Department of the Affiliated Hospital of Yunnan University,Kunming 650000,China)

机构地区：[1]云南大学附属医院急诊医学部,云南昆明650000 [2]北京协和医院急诊科,北京100730

出　　处：《中国急救医学》2023年第9期685-689,共5页Chinese Journal of Critical Care Medicine

基　　金：云南省于学忠专家工作站项目(202105AF150026);云南省科技计划重点项目(202301AS070037)。

摘　　要：目的分析急性亚稀褶红菇中毒的临床特点。方法回顾性分析2020年1月至2022年12月云南大学附属医院急诊内科收治的71例急性亚稀褶红菇中毒患者临床资料,根据是否发生横纹肌溶解分为横纹肌溶解组(n=33)和非横纹肌溶解组(n=38),对比分析两组临床特征。结果①横纹肌溶解组年龄、住院时间大于非横纹肌溶解组(P<0.05)。两组性别、食用后就诊时间、潜伏期差异无统计学意义(P>0.05)。②几乎所有的急性亚稀褶红菇中毒患者均以胃肠道症状首发,随后出现横纹肌溶解症状。③横纹肌溶解组入院白细胞计数(WBC)、中性粒细胞计数(NEU)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、尿酸(UA)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)和心肌肌钙蛋白I(cTnI)高于非横纹肌溶解组,淋巴细胞计数(LYM)低于非横纹肌溶解组(P<0.05)。④发生器官/系统功能损害的病例均源于横纹肌溶解组,其中肝、心肌、肾及循环系统受累最常见。⑤急性亚稀褶红菇中毒死亡病例均源于横纹肌溶解组,其病死率为27.27%。结论亚稀褶红菇是横纹肌溶解型毒蕈,其中毒后潜伏期短,病死率高,应早期识别及治疗。Objective To analyze the clinical characteristics of acute Russula subnigricans Hongo.Methods The clinical data of 71 patients with acute Russula subnigricans Hongo poisoning admitted to the Emergency Internal Medicine Department of the Affiliated Hospital of Yunnan University from January 2020 to December 2022 were analyzed retrospectively.The patients were divided into the rhabdomyolysis group(n=33)and the non-rhabdomyolysis group(n=38)based on whether rhabdomyolysis has occurred,and the clinical characteristics of the two groups were compared and analyzed.Results①The age was older and hospitalization time was longer in the rhabdomyolysis group than those in the non-rhabdomyolysis group(P<0.05).There was no statistically significant difference in gender,visit time,and incubation period between the two groups(P>0.05).②Almost all the patients experienced gastrointestinal symptoms as the first symptom,and the symptoms of rhabdomyolysis occurred subsequently.③The admission WBC,NEU,ALT,AST,CK,CK-MB,LDH and cTnI of the rhabdomyolysis group were higher than those of the non-rhabdomyolysis group,while lymphocyte(LYM)was lower than that of the non-rhabdomyolysis group(P<0.05).④The occurrence of organ/system functional damage all originated in the rhabdomyolysis group,the liver,myocardium,kidney and circulatory system were the most commonly affected.⑤The death cases of acute Russula subnigricans Hongo poisoning were all in the rhabdomyolysis group,and the mortality rate is 27.27%.Conclusions Russula subnigricans Hongo is a rhabdomyolytic mushroom with a short latency after poisoning,resulting in a high mortality rate.Therefore,early identification and treatment are necessary.

关 键 词：亚稀褶红菇 蕈类中毒 横纹肌溶解综合征 

分 类 号：R595.6[医药卫生—内科学]