云南省楚雄州315例蘑菇中毒的时空分布、临床分型及物种多样性分析  

Analysis of Spatiotemporal Distribution,Clinical Classification and Species Diversity on 315 Cases of Mushroom Poisoning Occurring in Chuting Prefecture,Yunnan Province of China

作　　者：李吉品 姚群梅 余成敏 李海蛟[3] 陈冲贵 毕晓丽 钟加菊 LI Jipin;YAO Qunmei;YU Chengmin;LI Haijiao;CHEN Chonggui;BI Xiaoli;ZHONG Jiaju(Department of Emergency Medicine,The People's Hospital of Chuxiong Yi Autonomous Prefecture,Chuxiong 675000,China;College of Pharmacy,Dali University,Dali 671000,China;National Institute for Occupational Health and Poison Control,Chinese Center for Disease Control and Prevention,Beijing 100050,China)

机构地区：[1]楚雄彝族自治州人民医院急诊科,楚雄675000 [2]大理大学药学院,大理671000 [3]中国疾病预防控制中心职业卫生与中毒控制所,北京100050

出　　处：《菌物研究》2024年第4期333-341,共9页Journal of Fungal Research

基　　金：云南省院士专家工作站项目(202305AF150066);楚雄州人民医院院内项目(2023Y01)。

摘　　要：楚雄州是云南省蘑菇中毒最严重的地区之一,但蘑菇中毒的时空分布、临床分型及常见毒蘑菇物种尚不完全清楚。对2014—2023年楚雄彝族州人民医院收治的315例住院患者进行了系统分析,结果显示:蘑菇中毒时间集中在6—9月(占比92.38%),死亡时间集中在7—8月(占比93.10%),死亡29例(9.21%)。中毒及死亡事件在楚雄州8县2市均有分布,中毒人数排在前5位的地区分别是楚雄市(37.46%)、牟定县(13.65%)、大姚县(12.38%)、南华县(10.79%)和禄丰市(8.89%),死亡人数排名前5位的地区分别是楚雄市(31.03%)、禄丰市(20.69%)、牟定县(17.24%)、大姚县(10.34%)和双柏县(10.34%)。共涉及7个临床分型:急性肝损害型(116例、死亡24例),急性肾衰竭型(30例、死亡1例),神经精神型(69例),胃肠炎型(59例),光过敏性皮炎型(21例),横纹肌溶解型(12例、死亡2例),未确定型(8例、死亡2例)。47起中毒事件鉴定出29种毒蘑菇,致命鹅膏Amanita exitialis导致15例中毒4例死亡,亚稀褶红菇Russula subnigricans导致3例中毒2例死亡,毒沟褶菌Trogia venenata导致7例中毒、院外死亡3例,以上3种是楚雄州最危险的剧毒蘑菇物种;肉褐鳞环柄菇Lepiota brunneoincarnata导致2例中毒,为楚雄州首次报道的中毒物种;兰茂牛肝菌Lanmaoa asiatica导致8例中毒,是楚雄州常见的神经精神型蘑菇物种;叶状耳盘菌Cordierites frondosa导致6例中毒,是楚雄州造成光过敏性皮炎型中毒的唯一物种。研究结果初步揭示了楚雄州蘑菇中毒的分布特点,为后续蘑菇中毒精准防控提供科学依据。While Chuxiong Prefecture is one of the areas suffering the most severe mushroom poisoning in Yunnan Province,the spatiotemporal distribution,clinical classification of poisoning and common poisonous species of mushrooms are still not well analyzed.In this study,a systematic analysis using 315 inpatients,who were admitted to the People's Hospital of Chuxiong Prefecture due to the mushroom poisoning during the time from 2014 to 2023,was conducted.The results showed that the mushroom poisoning was occurring mostly within a period from June to September(92.38%)and the patient death was happened intensively during the time from July to August(93.10%),when 29 inpatients died(9.21%).Regions with the cases of poisoning and death were distributed in eight counties and two cities in Chuxiong Prefecture.The top fives showing the most number of poisoning were Chuxiong City(37.46%),Mouding County(13.65%),Dayao County(12.38%),Nanhua County(10.79%),and Lufeng City(8.89%)while the top fives revealing the most number of deaths were Chuxiong City(31.03%),Lufeng City(20.69%),Mouding County(17.24%),Dayao County(10.34%)and Shuangbai County(10.34%),respectively.Six clinical classifications were recorded from the above inpatients:acute liver failure(116 cases with 24 deaths),acute renal failure(30 cases with one death),psycho-neurological(69 cases),gastroenteritis(59 cases),photosensitive dermatitis(21 cases)and rhabdomyolysis(12 cases with two deaths).Clinical classification for eight cases with two deaths was unknown.Totally,29 species of mushrooms were identified to be responsible for 47 poisoning cases,in which Amanita exitialis caused 15 cases with four deaths,Russula subnigricans caused three cases revealing two deaths and Trogia venenata caused seven cases,indicating strongly that the above three species of mushrooms were the most dangerous and toxic to the residents in Chuxiong Prefecture(three cases of deaths occurring outside the hospital).Lepiota brunneoincarnata that caused two cases of poisoning was known to be the first

关 键 词：蘑菇中毒 毒蘑菇鉴定 临床分型 时空分布 

分 类 号：Q949.32[生物学—植物学]