乌司他丁治疗不同类型急性胰腺炎的临床疗效

目的:探讨乌司他丁用于治疗不同类型急性胰腺炎的临床疗效和安全性。方法:收集2013年1月至2014年1月我院收治的急性胰腺炎患者84例,随机分为观察组与对照组,每组各42例,两组患者均给予常规治疗,对照组加用奥曲肽治疗,观察组在对照组的基础上加用乌司他丁治疗,观察和比较两组患者的临床疗效、治疗前后血清IL-6和TNF-α水平的变化及不良反应的发生情况。结果:观察组的总有效率为96.72%,显著高于对照组的85.71%;其中,两组急性水肿型胰腺炎的疗效相当(P0.05),但观察组出血坏死型胰腺炎的有效率显著高于对照组(P0.05)。治疗后,两组血清IL-6与TNF-α水平均较治疗前显著降低,并且观察组显著低于对照组(P0.05),水肿型胰腺炎患者血清IL-6及TNF-α水平显著低于出血坏死型胰腺炎患者,差异均具有统计学意义(P0.05)。两组均未发生肝肾功能损害,未见药物相关性不良反应。结论:乌司他丁用于辅助治疗急性胰腺炎能够明显下调炎症因子水平,临床疗效显著,对急性水肿型胰腺炎的疗效尤为显著,安全性好,值得推广应用。     

醋酸奥曲肽联合乌司他丁对重症急性胰腺炎患者血清ET、MCP-1、TNF-α、IL-6水平及预后的影响

目的:探讨醋酸奥曲肽联合乌司他丁对重症急性胰腺炎血清内皮素(ET)、单核细胞趋化因子蛋白1(MCP-1)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)水平及预后的影响。方法:纳入我院2017年1月至2018年9月收治的94例重症急性胰腺炎患者,并依据随机数字表法将其分为对照组47例与观察组47例。对照组患者给予乌司他丁治疗,观察组在对照组基础上结合醋酸奥曲肽治疗,两组疗程均为7～14 d。比较两组治疗的疗效,血淀粉酶和尿淀粉酶恢复正常时间,腹痛缓解时间、肠鸣音恢复时间和腹胀缓解时间,治疗前后血清ET、MCP-1、TNF-α、IL-6水平的变化及预后。结果:观察组治疗总有效率(93.62%)显著高于对照组(72.34%)(P0.05)。观察组血淀粉酶和尿淀粉酶恢复时间、腹痛缓解时间、肠鸣音恢复时间和腹胀缓解时间明显短于对照组(P0.05)。两组治疗后血清ET、MCP-1、TNF-α和IL-6水平均较治疗前降低(P0.05),且观察组以上指标均显著低于对照组(P0.05)。观察组出院时生存率高于对照组,但差异无统计学意义(P0.05)。结论:与单用乌司他丁相比,醋酸奥曲肽联合乌司他丁治疗重症急性胰腺炎患者疗效更好,其可显著降低患者血清ET、MCP-1、TNF-α和IL-6水平。     

连续性血液净化治疗联合乌司他丁对急性胰腺炎患者TLR4、血浆炎症因子及白介素的影响

目的:探究连续性血液净化联合乌司他丁对急性胰腺炎患者TLR4、白介素及血浆炎症因子的影响。方法:选择2014年1月至2016年1月我院接诊的72例急性胰腺炎患者,并采用随机的方法分为实验组与对照组各36例。实验组与对照组均进行基础治疗和乌司他丁治疗,而实验组还要进行连续性血液净化治疗。记录治疗后APACHEⅡ评分、住院时间、腹痛消失时间、血清淀粉酶恢复时间,测量患者治疗前和治疗一周后的TLR4、血浆炎症因子及白介素水平。结果:(1)实验组患者治疗后住院时间、血清淀粉酶恢复时间、APACHEⅡ评分、腹痛消失时间均显著低于或少于对照组患者(P0.05)。(2)相较于治疗前,两组患者治疗一周后的TLR4、CRP、IL-6和TNF-α水平均显著降低(p0.05);实验组患者治疗一周后的TLR4、CRP、IL-6和TNF-α的水平均显著低于对照组(p0.05)。(3)实验组的治愈率(34.29%)和总有效率(74.29%)均显著高于对照组的治愈率(14.29%)和总有效率(48.57%)。结论:连续性血液净化治疗联合乌司他丁对急性胰腺炎患者的抗炎效果相较于单独使用乌司他丁疗效显著,能更好地降低炎症反应,使得TLR4、血浆炎症因子及白介素等炎症因子降低。     

乌司他丁治疗急性胰腺炎的临床疗效及机制研究

目的:探讨乌司他丁对急性胰腺炎患者的临床疗效及可能机制。方法:收集我院收治的重症急性胰腺炎患者66例,随机分为实验组和对照组。所有患者均给予禁食水、充分补液、纠正电解质紊乱等常规支持对症治疗。对照组予奥曲肽,实验组予乌司他丁,共治疗7天。测定两组患者治疗前、后各血清白介素-6(IL-6)、白介素-8(IL-8)及肿瘤坏死因子-α(TNF-α)水平;治疗前、治疗第1、3天及治疗后进行血常规检测,观察白细胞计数(WBC),并进行血淀粉酶(AMS)、尿淀粉酶(UAMY)测定;分别记录两组患者临床症状及体征恢复时间,判定临床疗效。结果:1治疗后,两组患者血清IL-6、IL-8及TNF-α水平均较治疗前显著下降,且实验组较对照组下降更明显(P0.05);2治疗后,两组患者白细胞计数及血、尿淀粉酶水平均较治疗前明显下降,且实验组较对照组下降更明显(P0.05);3治疗后,实验组各项临床症状及体征消失时间均明显短于对照组(P0.05)。结论:乌司他丁可有效改善急性胰腺胰腺炎患者的各项临床症状,这可能与其显著降低其血清IL-6、IL-8、TNF-α、淀粉酶水平、白细胞计数及尿淀粉酶水平有关。     

乌司他丁联合前列地尔对急性胰腺炎的临床疗效及对血清TNF-α、IL-1β、HMGB1、HSP的影响

目的:探讨乌司他丁联合前列地尔治疗急性胰腺炎的临床疗效及对血清肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素(Interleukin-1 beta,IL-1β)、高迁移率组蛋白1(HMGB1)、热休克蛋白(HSP)的影响。方法:选择72例我院收治的急性胰腺炎患者并将其随机平均分为观察组和对照组。对照组按照常规方法治疗,观察组在常规治疗方法上采用乌司他丁联合前列地尔加入葡萄糖注射治疗。比较两组患者临床症状及体征恢复时间、治疗前后血清TNF-α、IL-1β、HMGB1、HSP水平的变化及血淀粉酶水平的恢复情况。结果:治疗后,观察组的总有效率为97.2%,对照组的总有效率为69.7%,观察组显著高于对照组(P0.05);观察组多个体征恢复时间均明显短于对照组(P0.05);两组血清TNF-α、IL-1β、HMGB1、HSP水平均较治疗前明显下降,且观察组以上指标均显著低于对照组(P0.05);观察组血淀粉酶水平恢复率明显高于对照组(P0.05)。结论:乌司他丁联合前列地尔治疗急性胰腺炎能有效提高其临床疗效,显著缩短临床症状及体征恢复时间、血淀粉酶恢复时间,降低患者血清TNF-α、IL-1β、HMGB1、HSP水平。     

加贝酯联合奥曲肽对急性胰腺炎患者胃肠功能、免疫功能及炎性因子水平的影响

目的:探讨加贝酯联合奥曲肽对急性胰腺炎(AP)患者胃肠功能、血清炎性因子及免疫功能的影响。方法:选取2014年1月到2018年6月在我院接受治疗的AP患者100例,采用随机数字表法将所有患者分为对照组和观察组各50例。对照组给予注射用醋酸奥曲肽治疗,观察组在对照组的基础上给予注射用甲磺酸加贝酯治疗。对比两组患者治疗后临床疗效、胃肠功能恢复情况、血清炎性因子水平及免疫球蛋白lgG、lgM、lgA的变化情况。结果:治疗后观察组总有效率为83.24%,高于对照组的67.03%(P0.05)。治疗后观察组排气恢复时间、排便恢复时间、肠鸣音消失时间、腹胀缓解时间、腹痛缓解时间均显著短于对照组(P0.05)。治疗后两组肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、白细胞介素-6(IL-6)及白细胞介素-8(IL-8)水平较治疗前均明显下降(P0.05),且治疗后观察组的TNF-α、CRP、IL-6及IL-8水平低于对照组(P0.05)。治疗后两组的lgG、lgM、lgA水平均较治疗前均明显升高(P0.05),治疗后观察组的lgG、lgM水平高于对照组(P0.05)。结论:加贝酯联合奥曲肽治疗AP不仅能够有效抑制患者的炎症反应,改善其免疫功能,还能够促进患者胃肠功能恢复,提高临床疗效。     

奥曲肽辅助十二指肠镜治疗急性水肿型胆源性胰腺炎疗效及对炎症反应的影响

目的:探讨奥曲肽辅助十二指肠镜治疗急性水肿型胆源性胰腺炎疗效及对炎症反应的影响。方法:选择急性水肿型胆源性胰腺炎患者100例,随机分为研究组与对照组各50例,两组患者均给予禁食、抗感染、营养支持、酶抑制剂治疗,对照组同期给予十二指肠镜治疗,研究组同期给予奥曲肽辅助十二指肠镜治疗,比较两组腹痛缓解时间,白细胞(WBC)、体温恢复正常时间,治疗前(T0)、治疗3d(T1)、治疗7d(T2)血、尿淀粉酶水平与炎症因子CRP、IL-6、TNF-α水平的变化。结果:(1)研究组腹痛缓解时间、WBC、体温恢复正常时间均较对照组明显缩短(P0.05);(2)两组患者T1、T2血、尿淀粉酶水平均较T0明显降低,且T2血、尿淀粉酶水平低于T1(P0.05),研究组T1、T2血、尿淀粉酶水平均低于对照组(P0.05);(3)两组T1、T2血清CRP、IL-6、TNF-α水平均较T0明显降低,且T2低于T1(P0.05),研究组T1、T2时血清CRP、IL-6、TNF-α水平均低于对照组(P0.05)。结论:奥曲肽辅助十二指肠镜治疗急性水肿型胆源性胰腺炎可提高早期治疗效果,减轻炎症反应。     

NMRC-DHP联合CVVH治疗脓毒症并发急性肾功能损伤的疗效观察

目的:探讨中性大孔径树脂血液灌流联合连续性静脉-静脉滤过治疗脓毒症并发急性肾功能损伤的临床疗效。方法:120名脓毒症并发急性肾功能损伤的患者随机分成两组,每组60例。观察组采用中性大孔径树脂血液灌流联合连续性静脉-静脉滤过(NMRC-DHP+CVVH)治疗;对照组采用连续性静脉-静脉滤过(CVVH)治疗。使用ELISA方法对两组患者CRP、TNF-α、IL-6及IL-10水平进行检测,并对两组APACHEⅡ评分进行比较。结果:(1)治疗后3 d、7 d、14 d,两组CRP、TNF-α和IL-6较治疗前显著下降,P0.05,而IL-10水平差异无统计学意义(P0.05);同期比较,观察组CRP、TNF-α和IL-6水平均低于对照组,P0.05,而IL-10水平无显著变化(P0.05);(2)治疗后3 d、7 d、14 d,两组APACHE II评分较治疗前显著下降,P0.05;同期比较,观察组APACHE II评分均低于对照组,P0.05。结论:相对于单独采用CVVH,采用NMRC-DHP联合CVVH治疗脓毒症并发AKI能够更加有效清除炎症介质,促进肾功能的恢复,疗效确切,值得临床推广。     

丙氨酰谷氨酰胺联合奥曲肽对重症急性胰腺炎患者的临床疗效

目的:探讨丙氨酰谷氨酰胺(Ala-Gln)联合奥曲肽治疗重症急性胰腺炎(SAP)的临床疗效及对患者血清白细胞介素-6(IL-6)、C反应蛋白(CRP)水平及相关生化指标的影响。方法:选取我院2013年1月~2016年12月收治的100例SAP患者,根据随机数字表法均分为两组。对照组仅予以奥曲肽治疗,观察组给予Ala-Gln联合奥曲肽治疗。记录比较两组的临床疗效、治疗前后血清IL-6、CRP、淀粉酶(AMY)、乳酸脱氢酶(LDH)、前清蛋白(PA)和白蛋白(ALB)水平的变化情况。结果:治疗10 d后,观察组总有效率为88.0%,明显高于对照组的64.0%(P0.05)。两组治疗10 d后血清IL-6、CRP、AMY、LDH水平均显著低于治疗前(P0.01),且与对照组对比,观察组血清IL-6、CRP、AMY、LDH水平的改善程度均更为显著(P0.01)。与治疗前相比,两组治疗10 d后血清PA、ALB水平均明显上升(P0.05),且观察组治疗10 d后血清PA和ALB水平的改善程度均显著优于对照组(P0.01)。结论:丙氨酰谷氨酰胺联合奥曲肽治疗更能有效消除或缓解重症急性胰腺炎患者的症状与体征,控制机体炎症反应,提高营养代谢水平,改善预后。     

乌司他丁对脓毒症急性肾损伤的临床疗效观察

目的:探讨乌司他丁治疗脓毒症急性肾损伤的临床效果及其可能机制。方法:选择我院2014年2月2016年8月收治的114例脓毒症急性肾损伤患者,按抽签法分为对照组(n=57)与实验组(n=57),对照组采用常规治疗,实验组基于对照组加以乌司他丁治疗,比较两组治疗前后尿液尿损伤分子-1(KIM-1)、心钠肽(ANP)、血清胱抑素-c(CYS-C)、白细胞介素1、6(IL-1、IL-6)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、一氧化氮(NO)、内皮素-1(ET-1)、免疫球蛋白A、G、M(IgA、IgG、IgM)、APACHE-Ⅱ评分。结果:治疗后,实验组尿液KIM-1、ANP、血清CYS-C、IL-1、IL-6、CRP、TNF-α、ET-1、APACHE-Ⅱ评分水平均显著低于对照组(P0.05),血清NO、IgA、IgG、IgM水平均明显高于对照组(P0.05)。结论:乌司他丁治疗可显著减轻脓毒症时急性肾损伤,可能与其抑制机体炎症反应,改善肾脏血流灌注,提高免疫功能有关。     

IL-4 和IL-12 在宫颈癌中的表达及对紫杉醇过敏的影响

目的:研究IL-4,IL-12在宫颈癌组织中的表达,探讨其对宫颈癌发生及术后对紫杉醇过敏的影响。方法:应用半定量逆反应-聚合酶链反应(RT-PCR)技术检测IL-4mRNA,IL-12p35以及IL-12p40 mRNA在正常宫颈组和宫颈癌组中的表达,并分析两者之间的相关性以对紫杉醇过敏的影响。结果:1.宫颈癌组中IL-4mRNA表达水平高于正常宫颈组,而IL-12p35和IL-12p40mRNA表达低于正常宫颈组,差异有统计学意义(P<0.05);2.在术后给予紫杉醇治疗的宫颈癌患者中,过敏组中IL-4mRNA的表达高于不过敏组;IL-12p35和IL-12p40mRNA则低于后者,差异有统计学意义(P<0.05)。结论:体内IL-12降低和(或)IL-4升高可促进宫颈癌的发生发展增加紫杉醇过敏的发生率。     

思连康治疗溃疡性结肠炎的疗效及机制研究

目的研究微生态制剂思连康辅助治疗溃疡性结肠炎的疗效及其可能的机制。方法将溃疡性结肠炎患者79例随机分成治疗组及对照组,治疗组40例,对照组39例。对照组采用常规治疗,治疗组在常规治疗的基础上加用双歧四联活菌制剂——思连康。比较2组治疗前及治疗2个月后患者的临床症状评分、结肠黏膜炎症表现、细胞因子IL-10、IL-18的变化。结果治疗2个月后2组临床症状评分、结肠黏膜炎症评分均较治疗前有明显改善（P〈0.01）,且治疗组临床症状、结肠黏膜炎症改善程度优于对照组（P〈0.01）,IL-10、IL-18的含量治疗前后有明显的变化,IL-10增加,IL-18降低。结论思连康可辅助治疗溃疡性结肠炎,其机制可能是通过调节细胞因子的变化,进一步影响结肠黏膜的免疫功能。     

Difference in response of NK cell activity in newborns and adult to IL-2, IL-12 and IL-15

The killing activity of cord blood mononuclear cells (cMNC) against cytomegalovirus (CMV)-uninfected and -infected fibroblasts was comparable to that of adult peripheral blood mononuclear cells (aPBMC). The killing activity of cMNC against K562 cells was significantly lower compared with that of aPBMC. Treatment of cMNC and aPBMC with interleukin-2 (IL-2), IL-12 or IL-15 significantly enhanced killing activity against K562 cells and CMV-uninfected and -infected cells. By comparison of cMNC with aPBMC, killing activity against the K562 cells of cMNC was augmented to the level of aPBMC when cultured with IL-2, IL-12 or IL-15. The killing activity of cMNC against CMV-uninfected and -infected fibroblasts did not increase to the level of adult PBMC by treatment with IL-2, IL-12 or IL-15. These data suggest that cord blood contains a functionally different NK cell subpopulation than that among adult NK cells.     

Potential role of myeloid cell/eosinophil-derived IL-17 in LPS-induced endotoxin shock

IL-17RA is a shared receptor subunit for several cytokines of the IL-17 family, including IL-17A, IL-17C, IL-17E (also called IL-25) and IL-17F. It has been shown that mice deficient in IL-17RA are more susceptible to sepsis than wild-type mice, suggesting that IL-17RA is important for host defense against sepsis. However, it is unclear which ligands for IL-17RA, such as IL-17A, IL-17C, IL-17E/IL-25 and/or IL-17F, are involved in the pathogenesis of sepsis. Therefore, we examined IL-17A, IL-17E/IL-25 and IL-17F for possible involvement in LPS-induced endotoxin shock. IL-17A-deficient mice, but not IL-25- or IL-17F-deficient mice, were resistant to LPS-induced endotoxin shock, as compared with wild-type mice. Nevertheless, studies using IL-6-deficient, IL-21Rα-deficient and Rag-2-deficient mice, revealed that neither IL-6 and IL-21, both of which are important for Th17 cell differentiation, nor Th17 cells were essential for the development of LPS-induced endotoxin shock, suggesting that IL-17A-producing cells other than Th17 cells were important in the setting. In this connection, IL-17A was produced by macrophages, DCs and eosinophils after LPS injection. Taken together, these findings indicate that IL-17A, but not IL-17F or IL-25, is crucial for LPS-induced endotoxin shock. In addition, macrophages, DCs and eosinophils, but not Th17 cells or γδ T cells, may be sources of IL-17A during LPS-induced endotoxin shock.     

The involvement of IL-6 and IL-8 in acute invasive gastroenteritis of children

The involvement of the proinflammatory cytokines, interleukin 8 (IL-8) and 6 (IL-6), was studied during the first 72 h of acute invasive gastroenteritis. Study population included 33 infants and young children aged six months to six years and seven age-matched controls. As a group, patients with acute invasive gastroenteritis had an increased serum level of IL-8 and IL-6 as compared with healthy controls (p < 0.002 and p < 0.001, respectively). Subjects were then divided into two groups based on stool cultures (proven and non-proven bacterial cultures). Patients with bacterial-proven acute invasive gastroenteritis tended to have increased IL-8 serum concentrations (p < 0.07) as compared with those with non-proven bacterial etiologies and IL-6 levels were only detected in subjects with positive bacterial cultures (p < 0.05). When dividing each sub-group into early and late blood drawing with respect to disease onset, no statistical differences were found in each group but subjects with bacterial-proven etiologies had significant higher IL-6 levels as compared with non-proven etiologies at the two time points (p < 0.019 and p < 0.015, respectively).In conclusion, the proinflammatory cytokines, IL-6 and IL-8, are involved in acute invasive gastroenteritis. The difference in IL-6, and to a lesser degree IL-8, between proven and non-proven bacterial etiologies, needs further investigation.     

Suppression of IL-2-induced SAA gene expression in mice by the administration of an IL-1 receptor antagonist

The hepatic acute phase response induced by the administration of interleukin (IL)-2 is most likely mediated by secondary cytokines. In this investigation, we examined the role of endogenous IL-1 in the synthesis of the hepatic acute phase protein serum amyloid A (SAA) during IL-2 treatment. The injection of IL-2 induced SAA gene expression in the liver. The concurrent administration of an IL-1 receptor antagonist (IL-1RA) markedly reduced hepatic SAA mRNA levels and, to a lesser extent, SAA protein levels in the serum. Although IL-1 is an inducer of IL-6 production, the administration of the IL-1RA had no effect on circulating IL-6 levels in IL-2-treated mice. These findings suggest that the production of IL-1 is an important factor in the induction of SAA mRNA in mice undergoing immunotherapy with IL-2.     

IL-23和IL-17在结核病中的研究进展

近年来结核病的发病率越来越高,随着对结核病免疫机制的进一步研究,发现了Th17、IL-23、IL-17在结核免疫保护中起着重要作用。对这免疫途径的研究有利于进一步阐明结核病的免疫机制和指导临床诊疗。     

重组人IL-17A和IL-17F的制备方法及活性测定

人IL-17A和IL-17F具有很高的同源性,在炎症性疾病、自身免疫性疾病和肿瘤中都发挥着重要的作用,是当前研究的热点.应用原核表达系统在大肠杆菌BL21(DE3)中高效表达了人IL-17A和IL-17F;经培养条件的优化,未发现可溶性目的蛋白的表达,免疫印记分析显示,重组蛋白位于包涵体中;对包涵体进行洗涤、凝胶过滤层析纯化和柱上复性,获得重折叠的可溶性蛋白;随后用SDS-PAGE对蛋白样品进行了纯度分析、采用免疫印记和质谱的方法鉴定蛋白产物成分、用ME3T3-E1和RAW264.7两个细胞株对IL-17A、IL-17F的生物学活性进行测定.结果显示,柱上复性的方法制备的谊重组蛋白具有较高的纯度和活性.建立的重组人IL-17A和IL-17F的制备方法可为相关研究中细胞因子的大量应用提供参考.     

Effect of exposure to interleukin-21 at various time points on human natural killer cell culture

Background aimsInterleukin-21 (IL-21) can enhance the effector function of natural killer (NK) cells but also limits their proliferation when continuously combined with IL-2/IL-15. Paradoxically, membrane-bound (mb)-IL-21 has been shown to improve human NK cell proliferation when cultured with IL-2/mb-IL-15. To clarify the role of IL-21, we investigated the effect of the timing of IL-21 addition to NK cell culture.MethodsIL-2/IL-15–activated NK cells were additionally treated with IL-21 according to the following schedules; (i) control (without IL-21); (ii) first week (day 0 to day 7); (iii) intermittent (the first 3 days of each week for 7 weeks); (iv) after 1 week (day 8 to day 14); and (v) continuous (day 0 to day 49). The expression of NK receptors, granzyme B, perforin, CD107a, interferon-γ, telomere length and NK cell death were measured by flow cytometry.ResultsCompared with the control (2004.2-fold; n = 10 healthy donors) and intermittent groups (2063.9-fold), a strong proliferative response of the NK cells on day 42 was identified in the “first week” group (3743.8-fold) (P < 0.05). NK cells treated with IL-21 in the “first week” group showed cytotoxicity similar to that in control cells. On day 28, there was a significant increase in cytotoxicity of “first week” NK cells that received IL-21 treatment for an additional 2 days compared with the “first week” NK cells (P < 0.05).ConclusionsThese data suggest that controlling temporal exposure of IL-21 during NK cell proliferation can be a critical consideration to improve the yields and cytotoxicity of NK cells.     

蛇毒与细胞因子研究进展

全世界共有蛇类2500余种,其中毒蛇约650余种,估计每年被毒蛇咬伤的人数在30万以上,死亡率约为10％。我国蛇类有160余种,其中毒蛇约有50余种。剧毒、危害剧大的有10种,如眼镜蛇王、金环蛇、眼镜蛇、五步蛇、银环蛇、蝰蛇、蝮蛇、竹叶青、烙铁头、海蛇等,咬伤后能致人于死亡。我国两广地区蛇害严重,每年蛇咬伤的发病率约为25/10000。蛇毒的成分比较复杂．主要由蛋白质、多肽类和多种酶类组成。蛇毒对机体的作用比较复杂,按其有毒成分的毒理作用可分为神经毒、血循环毒和混合毒三类。银环蛇、金环蛇、海蛇的蛇毒主要含神经毒,其主要作用特点为通过多种不同的方式阻断神经一肌肉接头的冲动传递而导致呼吸肌麻痹,是蛇伤致死的主要原因;蝰蛇、五步蛇、烙铁头和竹叶青的蛇毒主要含血循环毒,包括心脏毒、凝血毒、溶血毒、蛋白水解酶、透明质酸酶等;眼镜王蛇等蛇毒属于混合毒,此类蛇毒既含神经毒成分,又含血循环毒成分。