Evaluation of Effectiveness of Hemoperfusion by Serum Aconitine Levels in Severe Aconitum-Intoxicated Patients

以血漿藥物濃度評估血液灌洗對烏頭鹼中毒病人治療之成效

杞建佑(Chien-Yu Chi) ； 翁德怡(Te-I Weng) ； 陳儒佑(Ju-Yu Chen) ； 陳冠元(Guan-yuan Chen) ； 方震中(Cheng-Chung Fang)

《台灣法醫學誌》 12卷2期 (2020/12) Pp. 3-7

https://doi.org/10.6134/tjfm.202012_12(2).0002

摘要

Despite poisoning by Aconitum species, they are widely used as herbal medicines in Asia. There is no information on the changes in serum aconitine levels in patients under hemoperfusion. Herein, we report the relationship of clinical presentations and serum aconitine concentrations with hemoperfusion treatment in two patients. We found that the serum level of aconitine correlated with arrhythmia. Furthermore, early extra-corporeal membrane can improve survival in cases of fatal ventricular tachycardia/fibrillation. Our results affirm that hemoperfusion cannot accelerate the elimination of aconitine based on analysis the serum aconitine levels.

關鍵字

Aconitine Toxicity ； Arrhythmia ； Hemoperfusion ； Extra-Corporeal Membrane Oxygenation

並列摘要

儘管烏頭鹼中毒事件頻傳，但烏頭仍廣泛應用在亞洲的中草藥之中。至今未有研究報告指出烏頭鹼中毒後使用血液灌洗和血中烏頭鹼濃度的變化關係。本篇研究描述兩位病案因烏頭鹼中毒接受血液透析前後的血中濃度及相應的臨床症狀，我們發現中毒症狀和血液濃度呈高度相關性，而使用血液灌洗並未能顯著加快血中烏頭鹼的排除，另外一病案亦指出使用葉克膜（extra-corporeal membrane oxygenation, ECMO）可以增加烏頭鹼中毒造成之致死性心律不整病患的存活率。

並列關鍵字

烏頭鹼中毒 ； 心律不整 ； 血液灌洗 ； 葉克膜

參考文獻

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