用于蛇的F(ab') 2AV和FabAV的急性不良影响毒毒:一个为期四年的中毒中心研究
Justin A Seltzer1, Garret A Winkler2, Jeremy Hardin3
1Department of Emergency Medicine, UC San Diego Health, San Diego, CA, USA; San Diego Division, California Poison Control System, San Diego, CA, USA.
用Crotalidae多价羊免疫Fab抗毒 (FabAV) 和Crotalidae马免疫F(ab') 2抗毒 (F(ab') 2AV) 治疗蛇毒的治疗表明不良事件发生率较低. 严重的不良事件很少发生,F(ab') 2AV没有报告,而FabAV的不良事件为1.5%.
科学领域:
- 毒理学和药理学 毒理学和药理学
- 紧急医疗 紧急医疗
- 临床研究 临床研究
背景情况:
- 蛇中毒是美国Crotalid暴露的重要原因之一.
- 有两种主要抗毒药,Crotalidae多价羊免疫Fab抗毒药 (FabAV) 和Crotalidae马免疫Fab抗毒药 (FabAV),可用于治疗.
- 关于这两种抗毒药的不良影响概况的比较数据有限.
研究的目的:
- 为了比较FabAV和F(ab") 2AV之间的不良反应率,用于治疗蛇中毒的患者.
- 确定与每个抗毒药物相关的不良事件的发生率和类型.
主要方法:
- 报道给加利福尼亚毒药控制系统的蛇中毒病例的回顾性图表审查 (2018年10月 - 2022年8月).
- 纳入标准:接受FabAV或Fab") 2AV治疗的患者;排除标准:接受两种抗毒药的治疗.
- 副作用分为"严重" (涉及多器官系统,呼吸道胀,血液动力学不稳定) 或"不严重".
主要成果:
- 总共分析了481名患者:360人接受了FabAV治疗,121人接受了FabAV治疗.
- 非严重的不良事件:12名FabAV患者中有18人,而2名FabAV患者中有2人 (皮疹/尿疹最常见).
- 严重不良事件:5 (1.5%) 在FabAV组与0在Fab") 2AV组 (p=0.025).
结论:
- 无论是FabAV还是F(ab") 2AV,在治疗蛇中毒时,不良事件的总体发生率都很低.
- 与FabAV相比,在接受F(ab") 2AV治疗的患者中,严重不良事件的发生率明显较低.
- 毒药中心的数据表明,这两种抗毒药的安全性概况都是有利的,尽管局限性包括回顾性设计和数据一致性.
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