{"id":4953,"date":"2017-02-20T00:00:00","date_gmt":"2017-02-19T16:00:00","guid":{"rendered":"\/\/www.afterroberto.com\/?guid=4ad07d084dafc604d5d7184f3cfe982b"},"modified":"2018-08-21T15:21:36","modified_gmt":"2018-08-21T07:21:36","slug":"%e7%a9%ba%e8%85%b9%e5%90%83%e6%88%96%e8%87%b4%e4%bd%8e%e8%a1%80%e7%b3%96-%e6%9c%aa%e7%86%9f%e8%8d%94%e6%9e%9d%e6%af%92%e6%ad%bb%e4%ba%ba%ef%bc%9f","status":"publish","type":"post","link":"\/\/www.afterroberto.com\/%e7%a9%ba%e8%85%b9%e5%90%83%e6%88%96%e8%87%b4%e4%bd%8e%e8%a1%80%e7%b3%96-%e6%9c%aa%e7%86%9f%e8%8d%94%e6%9e%9d%e6%af%92%e6%ad%bb%e4%ba%ba%ef%bc%9f\/","title":{"rendered":"\u7a7a\u8179\u5403\u6216\u81f4\u4f4e\u8840\u7cd6 \u672a\u719f\u8354\u679d\u6bd2\u6b7b\u4eba\uff1f"},"content":{"rendered":"

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\u6587\uff1a\u912d\u5bf6\u83ef<\/p>\n

\u7de8\u8f2f\uff1a\u6881\u5c0f\u73b2<\/p>\n

\/\/www.afterroberto.com\/wp-content\/uploads\/2017\/02\/11VE012_X.jpg;<\/inline><\/p>\n","protected":false},"excerpt":{"rendered":"

【明報專訊】印度最大荔枝產地穆扎夫法爾普爾（Muzaffarpur），每年荔枝季節，當地都有大量兒童在果園食荔枝後不適，甚至死亡。<\/p>\n

印度兒童「荔枝中毒」，究竟是因感染寄生蟲？殺蟲劑惹禍？還是與荔枝有關？香港人經常參加荔枝團到果園即摘即食，究竟有沒有危險？<\/p>\n

兒童抽搐、神志不清 死亡率31%<\/p>\n

穆扎夫法爾普爾是印度最大的荔枝產區，自1995年開始，在每年五、六月荔枝盛產季節，都爆發季節性不明疾病，主要影響兒童，出現急性腦神經徵狀，如神志不清、全身抽搐等，死亡率極高。而當踏入七月，荔枝產季過去，疫情就會大大減退。<\/p>\n

由美國疾病控制及預防中心資助的印度醫學團隊，上月在著名醫學期刊《刺血針》（The Lancet）發表研究報告。研究員在當地兩家醫院蒐集數據，在2014年5至7月，共有390名兒童因為相關徵狀送院，其中122人死亡（佔31%）。<\/p>\n

未熟含兩種高濃度毒物<\/p>\n

研究報告指出，入院的小朋友大都有兩個特徵，一是低血糖，二是血液中的次甘氨酸 （Hypoglycin）和甲基環丙基甘氨酸（Methyl-cyclopropyl -glycine，簡稱MCPG）偏高。研究團隊到果園化驗，結果顯示，以上兩種物質在未成熟荔枝中濃度，較成熟荔枝高出一至兩倍。<\/p>\n

影響新陳代謝致低血糖<\/p>\n

香港中文大學醫學院內科及藥物治療學系教授、內分泌及糖尿科專科醫生馬青雲指出，「正常情况，次甘氨酸和MCPG這兩種物質不應在血液中出現，而在一些未成熟的水果中，它們含量高」。<\/p>\n

研究員開始懷疑，這與牙買加曾經出現的情况相似，一種名為阿開木（Ackee）的水果，曾引致當地人不適。香港急症醫學院臨牀毒理專科委員會主席劉飛龍醫生解釋，阿開木，又名西非荔枝果，與荔枝、龍眼屬同一「家族」，「未成熟的阿開木，含有有毒物質次甘氨酸，影響新陳代謝，令身體不能運用血糖」。<\/p>\n

營養不良空腹吃易中招<\/p>\n

印度小朋友出現「荔枝中毒」，馬青雲解釋，是有多個因素同時出現才發生，包括﹕貧窮地區營養較差的小朋友、空腹、進食含次甘氨酸和MCPG的未成熟荔枝。他解釋，由於當地小朋友沒有足夠食物，營養差，當荔枝果園結出荔枝，雖然未成熟，小朋友仍摘取充飢，結果兩種有毒物質影響新陳代謝；加上沒有足夠糧食，身體又沒有多餘的能量儲備，結果便出現低血糖徵狀。<\/p>\n

唔熟唔食 兒童勿食逾300克<\/p>\n

劉飛龍表示，香港未見過相關情况，因為香港人食荔枝「唔熟唔食」，亦甚少單以荔枝充飢，所以不用太擔心。然而，他提醒，荔枝當造季節時不少市民參加荔枝團，在荔枝園內「閒閒哋」食一兩斤，就要小心，尤其小朋友不應食過量，最好一次不要食超過300克。另外，一旦出現低血糖徵狀，如﹕頭暈、臉色蒼白、發抖、冒冷汗、心悸，可嘗試補充糖分，並盡快求醫。<\/p>\n

■知多啲<\/p>\n

抽絲剝繭找出病源 教育公眾防護<\/p>\n

研究人員為了尋找印度小朋友無故暴斃的原因，就像偵探查案一樣，抽查了病人的血液、尿液、脊髓液樣本化驗，又在環境中抽查了不同傳染病源、農藥、有毒金屬等，結果發現病人血液中的次甘氨酸和MCPG異常，就開始向荔枝埋首，化驗樹上的荔枝、跌在地上的荔枝、成熟的荔枝、未成熟的荔枝等，逐步拆開小朋友暴斃之謎。<\/p>\n

「當研究發現小朋友暴斃，是因為空腹食了未成熟的荔枝，當地相關官員就提醒父母和小孩，不要採食未成熟荔枝，病例就大幅下降。」香港中文大學醫學院內科及藥物治療學系教授馬青雲指山，《刺血針》這篇「荔枝中毒」報告，正好闡釋公共衛生的重要，當出現一個流行病，醫生和研究員找出病源，透過教育提醒公眾，令病情得以改善。<\/p>\n

文：鄭寶華<\/p>\n

編輯：梁小玲<\/p>\n

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