Clinical Analysis of 3 Patients with Toxic Hepatitis Caused by Mushroom Poisoning_West China Medical Journal

Authors：

SHI Yinghong , FENG Ping

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Keywords：

毒蕈中毒; 中毒性肝炎; 血浆置换; 肝移植

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目的：探讨毒蕈中毒所致中毒性肝炎的临床表现、治疗与预后关系。方法：对3例急性毒蕈中毒患者进行回顾性临床分析。结果：3例患者均出现中毒性肝炎，2例经治疗后好转，1例因多器官功能衰竭死亡。结论：中毒性肝炎如导致多脏器损害，预后差；及早洗胃，彻底清除毒物是救治关键；血浆置换治疗有一定疗效，肝移植是最有效的治疗手段。

Citation： SHI Yinghong,FENG Ping. Clinical Analysis of 3 Patients with Toxic Hepatitis Caused by Mushroom Poisoning. West China Medical Journal, 2008, 23(1): 118-119. doi: Copy

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1. [１]Iliev Y,Andonova SA,Kabaliev V.Our experience in the treatment of acute amanita phalloides poisoning[Ｊ].Folia Med (Plovdiv),1999,41(4):30．.
2. 陈灏珠.实用内科学[M].第10版，北京:人民卫生出版社,1998：711．.
3. Sanford T,Golomb M.RNA polymerase 2 from wildtype and a-amanitin-resistant strains of Caenorhabditis elegans[Ｊ].J Biol Chem,1983,258(21):12804．〖ＨＪ０．４２ｍｍ〗.
4. Schumann J,Tiegs G.Pathophysiological mechanisms of TNF during intoxication with natural or man-made toxins[Ｊ]．Toxicology，1999,138:103．.
5. Leist M,Gantner F，Bohlinger I,et al.murine hepatocyte apoptosis induced in vitro and in vivo by TNF-α requires transcriptional arrest[Ｊ].J Immunol,1994,153(4):1778-1788．.
6. Laskin DL.Nonparenchymal cells and hepatotoxicity[Ｊ].Semin Liver Dis,1990,10:293．.
7. Catalina MV,Núnez O,Ponferrada A,et al.Liver failure due to mushroom poisoning:clinical course and new treatment perspectives[Ｊ].Gastroenterol Hepatol,2003,26(7):417-420..
8. Enjalbert F,Rapior S,Nouguier-Soulé J,et al.Treatment of amatoxin poisoning:20-year retrospective analysis[Ｊ].Toxicol Clini Toxicol,2002,40(6):715-757..
9. Broussard CN,Aggarwal A,Lacey SR,et al.Mushroom poisoning-from diarrhea to liver transplantation[Ｊ].Am J Gastroenterol,2001,96(11):3195-3198..
10. Jander S,Bischoff J.Treatment of Amanita phalloides poisoning:I.Retrospective evaluation of plasmapheresis in 21 patients[Ｊ].Ther Apher，2000,4(4):303-307..
11. 张文武.急诊内科学[Ｍ]．第1版，北京:人民卫生出版社,2000：568－569．.
12. Mullins ME,Horowitz BZ.The futility of hemoperfusion and hemodialysis in amanita phalloides poisoning[Ｊ].Vet Hum Toxicol,2000,42(2):90．.

West China Medical Journal

Clinical Analysis of 3 Patients with Toxic Hepatitis Caused by Mushroom Poisoning

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