宜昌市182例毒蘑菇中毒患者的临床特征分析  

Clinical Characterization of 182 Patients with Poisonous Mushroom Poisoning in Yichang City

作　　者：郭建强 郑婷婷 张恒 张蓉[1] Guo Jianqiang;Zheng Tingting;Zhang Heng;Zhang Rong(Department of Emergency Medicine,Yichang Central People's Hospital,The First College of Clinical Medical Science,China Three Gorges University,Yichang 443003,China;Reproductive Medicine Research Center,Department of Gynecology and Obstetrics,Yichang Central People's Hospital,The First College of Clinical Medical Science,China Three Gorges University,Yichang 443003,China)

机构地区：[1]三峡大学第一临床医学院[宜昌市中心人民医院]急诊内科,湖北宜昌443003 [2]三峡大学第一临床医学院[宜昌市中心人民医院]妇产科生殖医学中心,湖北宜昌443003

出　　处：《巴楚医学》2025年第1期23-29,共7页Bachu Medical Journal

基　　金：湖北省自然科学基金项目(2024AFB845)。

摘　　要：目的:分析宜昌市毒蘑菇中毒患者的流行病学特点、临床特征及治疗转归,为提高毒蘑菇中毒患者的诊疗效果提供参考。方法:回顾性分析2014年5月—2024年5月于宜昌市中心人民医院就诊的182例毒蘑菇中毒患者,收集并分析所有纳入患者的一般临床资料,进一步分析流行病学特点、临床特征及治疗转归等情况。结果:患者发病时间主要集中在夏秋季,发病年龄为35~65岁,且以农民为主。中毒患者主要以消化道症状为主,包括恶心/呕吐(86.26%)、腹痛(59.89%)、腹泻(37.91%)等。患者临床分型主要集中在急性肝损型(48.90%),且重症患者占比为39.56%。患者心肌酶、肝肾功能及心电图等均有不同程度的异常改变。其中接受住院治疗的147例患者中,45例重症肝肾衰竭患者经过血液净化治疗后,患者丙氨酸转氨酶、肌酸激酶同工酶和凝血酶原活动度均较治疗前有所改善。结论:毒蘑菇中毒会造成肝、肾、心脏等多器官损伤,中毒症状一般可通过药物治疗进行改善,对于重症合并肝肾衰竭患者,经过血液净化治疗后,肝肾功能相关指标明显改善。为降低毒蘑菇中毒的发生风险,应加强相关的科普宣传教育,加强食源性疾病监测网络建设。Objective:To analyze the epidemiological characteristics,clinical features,and treatment outcomes of patients with mushroom poisoning in Yichang City,providing a reference for improving the diagnosis and treatment effects of patients with mushroom poisoning.Methods:A retrospective analysis was conducted on 182 patients with mushroom poisoning who were treated at Yichang Central People's Hospital from May 2014 to May 2024.General clinical data of all included patients were collected and analyzed,and the epidemiological characteristics,clinical features,and treatment outcomes were further analyzed.Results:The onset of patients was mainly concentrated in the summer and autumn seasons,with an age range of 35 to 65 years old,and farmers were the main group affected.The poisoning patients mainly presented with gastrointestinal symptoms,including nausea/vomiting(86.26%),abdominal pain(59.89%),and diarrhea(37.91%).The clinical classification of patients was mainly acute liver damage type(48.90%),and the proportion of severe patients was 39.56%.Patients had abnormal changes in myocardial enzymes,liver and kidney function,and electrocardiograms to varying degrees.Among the 147 patients who received hospital treatment,45 severe cases of liver and kidney failure underwent blood purification therapy,and the patients'alanine aminotransferase,creatine kinase isoenzyme-MB and prothrombin activity showed significant improvement compared to before treatment.Conclusion:Mushroom poisoning can cause damage to multiple organs such as the liver,kidneys,and heart.Generally,poisoning symptoms can be improved through medication treatment.For severe patients with combined liver and kidney failure,after blood purification treatment,the related indicators of liver and kidney function significantly improved.To reduce the risk of mushroom poisoning,it is necessary to strengthen the popularization of scientific education and the construction of foodborne disease surveillance networks.

关 键 词：毒蘑菇 蘑菇中毒 血液净化治疗 

分 类 号：R595.7[医药卫生—内科学]