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首页> 外文期刊>Transactions of the Royal Society of Tropical Medicine and Hygiene >Efficacy and safety of two whole IgG polyvalent antivenoms, refined by caprylic acid fractionation with or without beta-propiolactone, in the treatment of Bothrops asper bites in Colombia.
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Efficacy and safety of two whole IgG polyvalent antivenoms, refined by caprylic acid fractionation with or without beta-propiolactone, in the treatment of Bothrops asper bites in Colombia.

机译：通过在有或没有β-丙内酯的情况下通过辛酸分级分离提纯的两种完整IgG多价抗蛇毒的功效和安全性，在哥伦比亚治疗Bothrops叮咬。

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The efficacy and safety of two whole IgG polyvalent antivenoms (A and B) were compared in a randomised, blinded clinical trial in 67 patients systemically envenomed by Bothrops asper in Colombia. Both antivenoms were fractionated by caprylic acid precipitation and had similar neutralising potencies, protein concentrations and aggregate contents. Antivenom B was additionally treated with beta-propiolactone to lower its anticomplementary activity. Analysing all treatment regimens together, there were no significant differences between the two antivenoms (A=34 patients; B=33 patients) in the time taken to reverse venom-induced bleeding and coagulopathy, to restore physiological fibrinogen concentrations and to clear serum venom antigenaemia. Blood coagulability was restored within 6-24 h in 97% of patients, all of whom had normal coagulation and plasma fibrinogen levels 48 h after the start of antivenom treatment. Two patients (3.0%) had recurrent coagulopathy and eight patients suffered recurrence of antigenaemia within 72 h of treatment. None of the dosage regimens of either antivenom used guaranteed resolution of venom-induced coagulopathy within 6 h, nor did they prevent recurrences. A further dose of antivenom at 6 h also did not guarantee resolution of coagulopathy within 12-24 h in all patients. The incidence of early adverse reactions (all mild) was similar for both antivenoms (15% and 24%; P>0.05).
机译：在一项随机，双盲的临床试验中，对67例由Bothrops asper在哥伦比亚全身性感染的患者进行了随机，盲法临床试验，比较了两个完整IgG多价抗蛇毒血清（A和B）的疗效和安全性。两种抗氧化剂均通过辛酸沉淀进行分级，并具有相似的中和力，蛋白质浓度和聚集体含量。抗蛇毒B另外用β-丙内酯处理以降低其抗补体活性。一起分析所有治疗方案，在逆转毒液引起的出血和凝血病，恢复生理性纤维蛋白原浓度和清除血清毒液抗原血症所需的时间上，两种抗蛇毒素（A = 34例; B = 33例）之间没有显着差异。 。 97％的患者在开始抗蛇毒治疗后48小时内血液凝固能力恢复正常，所有患者的凝血和血浆纤维蛋白原水平均正常。 2例（3.0％）复发性凝血病，8例在治疗72小时内复发抗原血症。两种抗蛇毒血清的两种剂量方案均未在6小时内使用能保证解决由毒液引起的凝血病的方法，也未预防复发。在6 h再次给予抗蛇毒血清也不能保证所有患者在12-24 h内都能消除凝血病。两种抗癫痫药的早期不良反应（均为轻度）的发生率相似（分别为15％和24％; P> 0.05）。

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