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抗凝血灭鼠剂中毒的临床表现和诊断

Author
Diane P Calello, MD
Section Editor
Michele M Burns, MD, MPH
Deputy Editor
James F Wiley, II, MD, MPH
Translators
石秦东, 副主任医师

引言

本专题将总结抗凝血灭鼠剂中毒的临床表现和诊断。

抗凝血灭鼠剂中毒的处理以及其他灭鼠剂中毒的概述参见其他专题。(参见“灭鼠剂中毒概述”)

流行病学

抗凝血化合物在全球大部分地区中都是最常用的灭鼠剂。控制啮齿类动物数量是人类健康事业中不可或缺的工作，但如果灭鼠化合物也可使人类和家畜中毒，这份工作就要面对种种困难。理想的灭鼠剂应在小剂量时即对啮齿类动物产生剧烈毒性，但同时对非目标物种的毒性极低。抗凝血灭鼠剂最符合这一标准[1]。在20世纪40年代，抗凝血灭鼠剂随着华法林的使用而投入应用。耐华法林鼠类的出现促使研究者们研发了长效抗凝剂(又称为“超级华法林”)，如大隆、溴敌隆及氯敌隆。由于不难获取，抗凝血灭鼠剂在大量使用该药的国家中也是每年最常引起灭鼠剂中毒的原因，例如英国和美国[2,3]。

在美国，大隆是最常使用的抗凝血灭鼠剂[4]，但该药的应用存在全球差异。英国最常使用的是联苯杀鼠萘、大隆和溴敌隆[5]。在发展中国家里，华法林灭鼠剂导致过新生儿不慎暴露的悲剧，以及摄入华法林污染食品引起的人类死亡[6,7]。

全世界绝大多数抗凝血灭鼠剂暴露都发生于年幼儿童，他们一般仅摄入少量灭鼠剂，并且不会发生严重的凝血病[4,7-9]。但故意暴露或职业性暴露引起凝血病的概率要高得多。

               

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Literature review current through: 2017-06 . | This topic last updated: 2016-07-25.
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