医药学论文：群体性雪卡毒素鱼中毒的临床研究

关键词："老虎斑"鱼;中毒;雪卡毒素
摘要:目的 探讨"老虎斑"鱼中毒的临床特征和神经电生理变化特点。 方法 分析63例因食用"老虎斑"鱼中毒患者的临床特征，并测定63例中毒患者和60例正常人（对照组）的正中神经及胫神经的神经传导速度。 结果 进食有毒鱼0.5～24h后均先后出现消化、心血管和神经系统症状。63例患者感觉异常均持续2周以上:其中温度感觉倒错占54.0%，唇周舌咽喉麻木占33.3%，四肢肌肉感觉异常占65.1%，皮肤搔痒、蚁爬感占61.9%，视觉异常占14.3%。神经电生理检测显示:正中神经在早期（2周内）的感觉神经传导速度（SCV）异常检出率为36.5%、运动神经传导速度（MCV）异常检出率为11.1%，胫神经在早期的SCV异常检出率为60.3%、MCV异常检出率为14.3%，而三叉神经SCV未见明显异常。 结论 "老虎斑"鱼中毒临床表现在消化、心血管、神经三大系统，可造成持续长时间的神经感觉异常，并以温度感觉倒错最具特征性，其周围神经损害主要在肢体远端，且下肢重于上肢，而无颅神经损害体征。
关键词:"老虎斑"鱼;中毒;雪卡毒素
Clinical analysis of a collective ciguatoxin poisoning accident in a banquet.
Abstract:Objective To explore the clinical feature in patients with tiger spot fish poisoning. Methods 63patients with tiger spot fish poisoning were observed.The nerve conduction velocity were determined in63patients and60controls. Results Symptoms usually appeared0.5～24hours after eating poisonous fish.The re were gastrointestinal，cardiovascular and neurological symptoms.The duration of paresthesia in63patients lasted for two weeks.temperature perversion were observed in54.0%patients.Lips，tongue and throat numbness with paresthesia were accounted for33.3%.Paresthesia at arms and legs muscle accounted for65.1%.and61.9%in skin.Sense of vision with paresthesia accounted for14.3%.36.5%abnormality rate was observed sensory never conduction velocity（SCV）of median nerve in2weeks.Abnormality rate in SCV of tibial nerve was11.1%and14.3%abnor-mality rate of mote never conduction velocity（MCV）in median and tibial nerve was observed.Trigeminal nerve abnormality did not occur. Conclusion The clinical symptoms of tiger spot fish poisoning includes gastrointestinal，cardiovascular and neurological symptoms.The tiger spot fish poisoning can lead to persistent paresthesia with characteristic temperature perversion.Peripheral nerves damage is more severe in farther limbs.