青褶伞中毒的物种鉴定、中毒特征及救治

目的 探索褶伞属青褶伞的物种鉴定,总结青褶伞中毒诊断及救治方法,为该蘑菇造成的中毒事件处理和中毒患者救治提供借鉴.方法 结合中毒案例,收集流行病学、临床诊断救治资料和可疑毒蘑菇样本,对毒蘑菇样本进行形态学和分子生物学鉴定,并对青褶伞造成的中毒特征及救治进行梳理.结果 2名中毒患者食用了不等量的,自行采集的白色野生蘑菇;发病潜伏期约4h.主要临床表现为恶心、呕吐、腹痛、腹泻(呈稀水样便),一名患者伴有谷丙转氨酶和谷草转氨酶的升高,另一名患者呕吐少量淡红色液体,并在第2天伴有淡血性稀水便.给予足量补液、激素、保肝、青霉素抗感染等对症支持治疗,3d后全部治愈出院.毒蘑菇样本通过形态学结合分子生物学方法鉴定为青褶伞(chlorophyllum molybdites).结论 该中毒事件是一起由青褶伞引起的经口中毒,青褶伞菌为有毒蘑菇,主要引起消化道刺激性改变,病情较轻,病程短;形态学结合分子生物学方法对青褶伞的物种鉴定是识别青褶伞的有效方法.

Species identification,poisoning symptoms and medical treatment of chlorophyllum molybdites

Objective To study species identification,poisoning symptoms and medical treatment of chlorophyllum molybdites in order to provide a guideline and proper treatment.Methods Based on the data of epidemiological investigation,clinical treatment data and suspicious poisonous mushroom samples collected of present patients.The collected mushroom specimen was identified by morphological combined molecular methods,and the poisoning symptoms and medical treatment of C.molybdites were summarized systematically.Results Epidemiological investigation showed that two patients ate some white wild mushrooms collected by themselves.About 4 h after mushroom eaten,they had nausea,vomiting,stomachache and diarrhea (watery).Glutamate-puruvate transaminase and serum glutamic-oxaloacetic transaminase in serum increased in one patient,and the other patient vomited a little faint blood fluid,followed by faint blood fluid and watery diarrhea on the second day.After treatment with adequate rehydration,corticosteroid,liver protection and anti-infection using penicillin,both patients recovered after 3 days.The mushroom eaten by the patients was C.molybdites,as evidenced by morphological and molecular analysis.Conclusions The poisoning cases in the present study were caused by C.molybdites,confirmed by morphological and molecular analysis which is suitable for species identification.Chlorophyllum molybdites is a poisionous mushroom,whhich mainly causes digestive illness,and the illness is usually mild with short disease course.