■我国合法药品的销售有所增加。这些物质之一是kratom。Kratom(Mitragynaspeciosa)是阿片类κ的部分激动剂,mu,和δ受体。它在低浓度时起到兴奋剂的作用,让用户感觉更有活力和欣快。它在较高剂量下具有镇静和抗伤害作用。
■一名18岁男子在足球训练中晕倒,需要心肺复苏;最初的心律是通过除颤控制的心室纤颤。实验室参数不显著。送去进行毒理学评估的血液样本对kratom和咖啡因呈阳性。超声心动图检查,冠状动脉计算机断层扫描血管造影,和心脏磁共振成像没有证实原因。基因检测未发现与家族性室颤相关的致病基因变异,但是在MYOM1中发现了一个未知意义的变体。鉴于这种情况,我们根据欧洲心脏病学会(ESC)的指南,在心源性猝死(SCD)二级预防中植入了植入式心律转复除颤器(ICD).通过对我们的患者进行动态ICD记忆检查,未报告室性心律失常复发。
■在某些国家/地区,kratom是免费提供和出售的植物,不是毒品。文献中仅描述了使用kratom后发生心室纤颤的情况。没有足够的科学证据将kratom与心室纤颤联系起来。这是绝对关键的这类病例报告,在世界类似情况下尚未出版。因此,心室纤颤的发展被认为是由于kratom的组合,咖啡因,和锻炼。kratom的安全性和作用应该是未来研究的主题。我们要强调,必须报告更多的病例系列,以获得更多的科学证据,从而增加一些国家对kratom的更严格供应和监管的压力,尤其是在非处方药的地方.
UNASSIGNED: There is an increase in the sale of legal drugs in our country. One of these substances is kratom. Kratom (Mitragyna speciosa) is a partial agonist of the opioid kappa, mu, and delta receptors. It acts as a stimulant at low concentrations, making users feel more energetic and euphoric. It has sedative and antinociceptive effects at higher doses.
UNASSIGNED: An 18-year-old man collapsed during football training and required cardiopulmonary resuscitation; the initial rhythm was ventricular fibrillation managed by defibrillation. Laboratory parameters were unremarkable. Blood samples sent for toxicological evaluation were positive for kratom and caffeine. Echocardiographic examination, coronary computed tomography angiography, and cardiac magnetic resonance imaging did not prove the cause. Genetic testing did not find a pathogenic gene variant associated with familial ventricular fibrillation, but a variant of unknown significance was found in MYOM1. Given this situation, we implanted an implantable cardioverter-defibrillator (ICD) from the secondary prevention of sudden cardiac death (SCD) according to the guidelines of the European Society of Cardiology (ESC). No recurrence of ventricular arrhythmia has been reported by ambulatory ICD memory checks on our patient.
UNASSIGNED: In some country, kratom is freely available and sold as a plant, not a drug. Only incident cases of ventricular fibrillation after kratom use are described in the literature. There is insufficient scientific evidence linking kratom to ventricular fibrillation. This is an absolutely crucial
case report of this type, which has not yet been published in similar circumstances in the world. Therefore, the development of ventricular fibrillation was assumed to be due to a combination of kratom, caffeine, and exercise. The safety profile and effects of kratom should be the subject of future research. We would like to stress the importance of reporting further
case series for more scientific evidence and thus increasing the pressure for stricter availability and regulation of kratom in some countries, especially where it is over-the-counter.