Snakebite envenoming
Snakebite envenoming
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DOI：
10.1038/nrdp.2017.63
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发表时间：
2017-09-14
影响因子：
81.5
通讯作者：
Warrell, David A.
中科院分区：
文献类型：
--
作者：
Gutierrez, Jose Maria;Calvete, Juan J.;Warrell, David A.
毒蛇咬伤是一种被忽视的热带疾病，每年造成10万人死亡，40万人致残。生活在热带农村地区的贫困人口特别脆弱;毒蛇咬伤使贫困的循环永久化。蛇毒是蛋白质的复杂混合物，具有广泛的毒性作用。蛇毒成分的高度可变性是毒液蛰入的各种临床表现的原因，从局部组织损伤到可能危及生命的全身效应。静脉注射抗蛇毒血清是对抗毒液中毒的唯一特效疗法。还使用止痛剂、呼吸机支持、输液治疗、血液透析和抗生素治疗。正在探索基于重组抗体技术和新毒素抑制剂的新型治疗替代方案。在全球一级应对毒蛇咬伤中毒需要实施一项综合干预战略，涉及世卫组织、研究界、抗蛇毒血清制造商、监管机构、国家和区域卫生当局、专业卫生组织、国际资助机构、宣传团体和民间社会机构。
Snakebite envenoming is a neglected tropical disease that kills >100,000 people and maims >400,000 people every year. Impoverished populations living in the rural tropics are particularly vulnerable; snakebite envenoming perpetuates the cycle of poverty. Snake venoms are complex mixtures of proteins that exert a wide range of toxic actions. The high variability in snake venom composition is responsible for the various clinical manifestations in envenomings, ranging from local tissue damage to potentially life-threatening systemic effects. Intravenous administration of antivenom is the only specific treatment to counteract envenoming. Analgesics, ventilator support, fluid therapy, haemodialysis and antibiotic therapy are also used. Novel therapeutic alternatives based on recombinant antibody technologies and new toxin inhibitors are being explored. Confronting snakebite envenoming at a global level demands the implementation of an integrated intervention strategy involving the WHO, the research community, antivenom manufacturers, regulatory agencies, national and regional health authorities, professional health organizations, international funding agencies, advocacy groups and civil society institutions.