CAJ | 학술논문

曼陀罗为草本茄科植物，全株有毒，其主要成分是莨菪碱、阿托品及东莨菪碱等生物碱，中毒后轻者主要表现为口、咽喉发干，吞咽困难，瞳孔散大、谵语幻觉、心率增快等，严重者可发生昏迷、抽搐甚至呼吸、循环衰竭而死亡。该文报道1例曼陀罗中毒的老年患者，因突发意识不清入院，由于患者有高血压病史，且行头颅 CT 显示右侧颞叶局部密度稍低，考虑到老年危重病患者的重点疾病多为脑血管和循环系统疾病，故初诊医师按脑卒中给予治疗，但疗效不明显，后经接班医师继续追问病史，明确患者发病前2 h 曾因关节痛而饮用曼陀罗籽浸泡的药酒，不排除曼陀罗中毒的可能而予以新斯的明0．5 mg 肌内注射，患者病情逐渐好转，最后明确诊断为曼陀罗中毒。因此，对于以意识障碍为首发症状就诊而且有高血压病史的曼陀罗中毒老年患者，应详细询问病史、完善各项检查以避免将其误诊为急性脑血管意外。
만타라위초본가과식물，전주유독，기주요성분시랑탕감、아탁품급동랑탕감등생물감，중독후경자주요표현위구、인후발간，탄인곤난，동공산대、섬어환각、심솔증쾌등，엄중자가발생혼미、추휵심지호흡、순배쇠갈이사망。해문보도1례만타라중독적노년환자，인돌발의식불청입원，유우환자유고혈압병사，차행두로 CT 현시우측섭협국부밀도초저，고필도노년위중병환자적중점질병다위뇌혈관화순배계통질병，고초진의사안뇌졸중급여치료，단료효불명현，후경접반의사계속추문병사，명학환자발병전2 h 증인관절통이음용만타라자침포적약주，불배제만타라중독적가능이여이신사적명0．5 mg 기내주사，환자병정축점호전，최후명학진단위만타라중독。인차，대우이의식장애위수발증상취진이차유고혈압병사적만타라중독노년환자，응상세순문병사、완선각항검사이피면장기오진위급성뇌혈관의외。
Datura stramonium is a category of freely branching herb and all parts of the plant are poi-sonous,which contain essential components of hyoscyamine,atropine and tropane alkaloids.Mild Datura stra-monium intoxication typically leads to mouth and throat dryness,dysphagia,mydriasis,delirious speech,hal-lucination and tachycardia,etc.Severe patients may present with coma,spasm and even death induced by res-piration and circulatory failure.We reported one elderly patient intoxicated by Datura stramonium.The patient was admitted to hospital with a sudden disturbance of consciousness.The patient had a medical history of hy-pertension.Head CT scan revealed relatively low density of the right temporal lobe.Considering the high risk of cerebral vascular and circulatory system diseases for the aged population,the patient was primarily diagnosed with stroke and received corresponding therapy.However,no significant efficacy was achieved.After further inquiry of medical history,it was comfirmed that the patient had taken medicinal wine soaked with Datura stra-monium seed to release arthralgia two hours before onset.Considering the possibility of Datura stramonium in-toxication,the patient was administered with 0.5 mg of neostigmine via intramuscular injection and relevant symptoms were gradually mitigated.The patient was eventually diagnosed with Datura stramonium poisoning. Consequently,the possibility of Datura stramonium poisoning should be considered for elderly patients with ini-tial symptoms of consciousness disorder and a medical history of hypertension.Explicit inquiry of medical histo-ry and different necessary examinations should be fully performed to avoid the misdiagnosis of acute cerebrovas-cular events.