MT S LOI NM C PH BIN

Nm l mt trong nhng ngun thc phm b dng, cha hu nh y cc vitamin, mui khong cn thit cho c th, cha nhiu protein, axit amin. Nhng c mt s loi nm cha cht c m chng ta khng phn bit c vi nm n v trong bi ny s gip bn i cht. I. Nm Amanita pholoides Thuc h Amanitaceae, b agaricales ( nm tn), lp Hymenomycetes ( lp nm m n bo ), ngnh Basidiomycota ( ngnh nm m ). 1. c im hnh thi M nm: C hnh bn cu, mu xanh nht c khi trng tuyn( mu sc ph thuc vo ni m nm mc, ty tng vng kh hu), ng knh c khi ln ti 10cm. B mt m: Trn, khng c x, tha nm cn i mu trng. Chn tha nm: Hnh c, phnh ra. Tn di m c mu trng c khi xen ln mu xanh nht.

Vng cung

Bao gc

Amanita pholoides 2. Cht c Cht c ca nm Amanita phalloides l s tng hp ca hai loi cht c amatoxins v phallotoxin nm trong nhm amanitoxin.
3. Triu chng khi n phi nm A.phalloides au bng, nn ma d di, tiu chy sau 6 - 12 gi n phi. Suy

thn v gan, hn m v thng t vong.Him khi t vong xy ra trong 1 -2 ngy u do nn, a chy m thng t vong vo nhng ngy sau do suy gan. Vim d dy rut: nn thng km theo au bng qun, a chy d di gy mt nc v in gii nghim trng, mt s bnh nhn c th cht v sc trong vng 24 gi. Suy gan: tn thng c th xut hin trong vng 24 n 36 gi, enzym gan tng nhanh. Suy gan ti cp vi cc biu hin bnh no

gan, vng da, toan chuyn ho, ri lon ng mu nng. Khi c h ng huyt km theo th thng c tin lng xu v t vong nhanh. 4. C ch tc dng cht c a Amanitin( amatoxins) gy c nm A. phalloides, a-amanitin gn vo nhn RNA polymerase II ca t bo Enkaryotic v c ch tng hp n RNA gy cht t bo. Gan v thn l hai c quan ch tng hp protein tc cao nn thng b tn hi nng n.( 1941 by Heinrich O. Wieland and Rudolf Hallermayer of the University of Munich). Amatoxin l loi c t c c tnh cao v n nh, khng b phn hu bi nhit di bt c hnh thc ch bin no. c t ny c ch tng hp protein ca t bo do tng tc vi polymerase ca RNA. Amatoxin c hp thu rut v gy cht cc t bo rut sau 6 n 24 gi. Amatoxin c hp thu gan v thn gy vim v hoi t t bo gan nng, suy thn. Dc ng hc: Amatoxin nhanh chng c hp thu t rut v c vn chuyn ti gan nh qu trnh vn chuyn mt. Khong 60% ti hp thu nh chu trnh gan rut. c t ny c pht hin trong nc tiu t 90-120 pht sau n. Ngi ta khng tm thy cht chuyn ho no ca Amatoxin. 5. Liu lng ng c Amatoxin l loi c c t c nht trong s c t c bit. Liu ti thiu gy cht ngi l 0,1 mg/kg. Mt chic m ca nm Amanita c th cha ti 10-15 mg. 6. Gii c khi n phi nm Amanita phalloides Hi sc: m bo ng th, cho th oxy, t ni kh qun v thng kh nhn to khi cn.

 B nc v in gii tch cc v mt nc v in gii nhiu c th gy ra tt huyt p. Truyn Natriclorua 9%0 hoc ringerlactat 1020ml/kg bolus, sau truyn theo p lc tnh mch trung tm hoc thm ch truyn theo p lc ng mch phi. Thuc: silymarine (legalon) : c tc dng bo v gan, c ch cnh tranh vi amatoxin ti recepteur; thay i tnh thm ca mng t bo gan, c tc dng ngn chn c t vo gan, lm tng tng hp protein ca ribosom; thc y qu trnh hi phc ca t bo gan. ; vin 70mg, ung 420-800mg/ngy.
Chng ri lon ng mu bng truyn huyt tng ti ng

lnh. Ch nh ghp gan khi bnh nhn b suy gan ti cp.

Hin nay cha c thuc iu tr dc hiu khi b ng c. Nhiu

nghin cu trn ng vt v cc nghin cu so snh hi cu trn ngi thy rng nu iu tr sm bng silibinin tim tnh mch chm vi liu 20-50mg/kg/ngy, hoc vi penicillin G (Benzylpenicillin) liu cao. Thc nghim trn ng vt chng minh penicillin G c tc dng c ch hp thu amatoxin vo gan. Nghin cu hi cu trn lm sng cng cho thy liu cao penicillin lm gim t l t vong (Floersheim v cs 1982). Penicillin G liu 500 000 UI/kg/ngy hay 300mg/kg/ngy dng trong 3 ngy. II. Nm Amanita muscaria Thuc h (Anitaceae), b nm tn(Agaricales ), phn lp nm m n bo ( Hymenomycetes ), lp ( Agaricomycetes ), ngnh nm m ( Basidiomycota ). 1. c im hnh thi Qu nm c mu rc hay cam hay mu vng , mu sc c th m hay nht ty thuc vo mi trng M nm c ph nhng vy mu trng.

 ng knh m nm t 10-15cm, cung v vng mu trng hoc

vng, chn phnh dng c, tht nm trng khng c mi c bit.

Bao gc

Amanita muscaria

Vy nm

Amanita muscaria( mu vng ) 2. Cht c Nm cha cholin, muscarin v muscaridin. Muscarin gy tc hi cho h thn kinh giao cm. Cholin khng c lm nhng khi b xy ho th thnh cht rt c. Hot cht gy c l muscimol (3hydroxy-5-aminomethy1isoxazol - mt sn phm ca qu trnh xy ha hoc lm kh ca acid ibotenic)
3. Triu chng khi n phi nm Ngi n phi loi nm ny sau 30 pht n 2 gi s c du hiu

chng mt, hoa mt, tht iu, long chong, tot m hi, chy nc di, nn ma v a chy. Sau c du hiu co git, hung

hng, lo lng o gic, ng t co, phn x nh sng gim. Nu ng c nng c th gy m sng, co git, lit trung khu h hp v t vong. 4. Liu lng ng c
Ngi v ng vt n phi 6 mg muscimol hoc 30 60 mg

ibotenic acid l c th gy t vong. 5. iu tr ng c Cha c thuc gii c tr III. Amanita pantherina Thuc h (Anitaceae), b nm tn(Agaricales ), phn lp nm m n bo ( Hymenomycetes ), lp ( Agaricomycetes ), ngnh nm m ( Basidiomycota ). 1. c im hnh thi
Qu nm c mu nu, ng knh khong 4-10cm, tht nm mu

trng, mi thm ca c ci v v ngt nh, cung nm di khong 7 -11 cm, ng knh cung 1-2,5 cm, nc ta mc nhiu Tam o, Ha Bnh v Lt. Nm gy c nhanh ch sau 1-2gi sau khi n. Nhn bn ngoi th nm ny kh ging vi nm Amanita muscaria

Vy nm

Vng cung

Bao gc

Amanita pentherina 2. Cht c Thnh phn v liu lng cht gy c ca A.pantherina ging vi A.muscaria IV. Amanita verna Thuc h (Anitaceae), b nm tn(Agaricales ), phn lp nm m n bo ( Hymenomycetes ), lp ( Agaricomycetes ), ngnh nm m ( Basidiomycota ). 1. c im hnh thi Qu nm mu trng, i khi gia c mu vng bn, b mt khi thi tit kh th nhn bng, khi tri m th t v dnh. Phn nm mu trng, ng knh khong 5-10cm, cung v vng cng mu trng, chn phnh dng c. Mc pha nam nc M 2. Cht c
Hot cht gy c l Amatoxin ging vi nm A.pholoides

 c ch gy c ging vi c ch ca A.pholoides ch yu lm suy

gan v tc ng mnh ln h tiu ha.

Qu th non ca A.verna V. Amanita virosa Thuc h (Anitaceae), b nm tn(Agaricales ), phn lp nm m n bo (Hymenomycetes ), lp ( Agaricomycetes ), ngnh nm m ( Basidiomycota ). 1. c im hnh thi
Qu nm mu trng, c hnh nn hoc nh nn trn, ng knh 4-

12cm, phin trng. Tht nm mu trng, mi kh chu. Nm mc vo ma thu, n c hoc thnh tng m. Cung di khong 15 cm

Vng cung

2. Cht c
Phallotoxins, amatoxins C ch v liu lng cht c gy cht ngi ging vi nm

Amanita pholoides
VI.

Russula emetica (nm xp gy nn ) Thuc h ( Russulaceae), b nm tn ( Russulales ), phn lp nm m n bo (Hymenomycetes ), lp ( Agaricomycetes ), ngnh nm m ( Basidiomycota ). 1. c im hnh thi M nm mu , c khi vng hoc vng nht ng knh t 3 10 cm, mc n c, cung nm di khong 7 cm, ng knh cung khong 1 cm ,. C mi d chu, v cay tnh nng.

2. Cht c
Hot ng ca cht c hin cha xc nh nhng thng gy nn.

VII.

Russula foetens Thuc h ( Russulaceae), b nm xp ( Russulales ), phn lp nm m n bo (Hymenomycetes ), lp ( Agaricomycetes ), ngnh nm m ( Basidiomycota ). 1. c im hnh thi

 M nm mu trng, i khi c mu vng bn gia, ng knh

m nm t 5 10 cm, cung di t 5 12 cm, ng knh cung nm 1,5 ti 4 cm, trong cung nm c nhiu vch ngn.

Russula foetens 2. Cht c lactapiperanol E lactapiperanol A VIII. Gyrramitra esculenta Thuc h (Discinaceae), b Pezizales), lp (Ascomycetes ), ngnh nm ti (Ascomycota ). 1. c im hnh thi
Nm c cc np nhn hnh no ngi, c mu nu ti mu

chiu cao nm 10 12 cm, ng knh m nm 15 cm, cung nm di 6 7 cm, ng knh cung nm 2 3 cm.

Gyrramitra esculenta 2. Cht c Monomethylhydrazine 3. triu chng khi n phi nm

Hi chng kch thch d dy rut xut hin mun sau n t 6-12

gi. Biu hin nn, a chy, chng mt, au u, yu c, sng, co git, tng mu, methemoglobin, c th gp suy gan hoc suy thn. 4. Liu lng ng c i vi tr nh: 10 30 mg/kg th trng i vi ngi ln v ng vt: 20 40 mg/kg th trng IX. Corinarius orellanus Thuc h (Cortinariaceae), b nm tn(Agaricales ), lp ( Homobasidiomycetae ), ngnh nm m ( Basidiomycota ). 1. c im hnh thi M nm c ng knh 3 9 cm c mu cam

Corinarius orellanus 2. Cht c Orellanine 3. Triu chng khi n phi nm

au bng, chn n, nn xy ra sau 24-36 gi, sau xut hin suy

thn t ngy th 3 n 14 ngy (hoi t ng thn). 4. Liu lng gy c 12 20 mg/kg trng lng c th Coprinopsis atramentaria Thuc h (Psathyrellaceae), b nm tn(Agaricales ), lp (Basidiomycetes ), ngnh nm m ( Basidiomycota ). c im hnh thi ng knh m nm 3 7 cm, cung nm di 7 17 cm, ng knh cung nm 1 1,5 cm, m nm c mu tro.

Coprinopsis atramentaria Cht c Coprine triu chng khi n phi nm mt , bun nn v nn, cm gic lo lng, kho th, chng mt sau khi n nm 5 10 pht, nu nh ung thm ru th tc dung s mnh hn v c th gy t vong.nu khng ung ru th thi gian tc dng khong 2 3 gi. Liu lng ng c Nu ung ru liu lng ng c l 5mg/ dl Nu khng ung ru liu lng ng c l 50 100 mg/ dl Cc nhm cht c ca nm c 1. Nhm Amanitoxin: Thng gp cc loi thuc chi Amanita nh: Amanita phalloides, A. verna, A. virosa vi cc triu chng khi trng c nh: au bng, nn ma d di, tiu chy sau 12 gi n phi. Suy thn v gan, hn m v thng t vong. 2. Nhm Gyromitin: Gp cc loi nm Gyromitra esculenta, Gyrometra infula sau 6 - 8 gi n nm c cm gic sng ph, bun nn, tiu chy, chut rt, u oi, thiu kim sot c, bn chn v trong mt s trng hp c th cht.
3. Orellaine:

 Gp mt s loi nm thuc chi Cortinarius nh: Cortinarius orellanus, C.speciosissimus. C triu chng: Rt kht nc, km nng v kh mi, nhc u, n lnh. au lng hoc au bng, nn ma. Tn thng thn sau 3 n 5 ngy.
4. Nhm Muscarine:

Thng gp cc loi nm thuc chi Clitocybe v Inocybe, l nhng loi nm nh, trng hoc nu, thng gp trn nhng bi c, gy ra triu chng 3 chy: Chy m hi, chy nc mt, chy nc bt. Co tht ng t, b o gic, co bp tht, tiu chy, tim p chm v tt huyt p. 5. Nhm Muscimol:
Gp cc loi thuc chi Amanita nh Amanita muscaria, A.

cokeri, A.gemmata, gy triu chng co bp tht, hoa mt, nn ma, hn m vi nhng o gic ch sau 2 gi n phi.

Amanita muscaria 6. Nhm Coprine: Ch gp Coprinus atramentarius vi triu chng mt v c nng st, tay chn c cm gic nh kin b. Tay t cng, tim p mnh, hi hp, nn ma nhng khng gy cht. Triu chng xy ra ch sau 30 - 60 pht n nm c km ung ru. Nng cn trong mu cng cao cng lm nng thm. 7. Nhm Psilocybin v Psilocin: Gp mt s loi nm thuc 4 chi: Psilocybe, Panaeolus, Conocybe v Gymnopilus. C triu chng: nh hng n thc. Gy o gic, ci v thc, cm thy khoan khoi v i khi cm thy nh xut hn ra khi xc. o gic nh LSD ca cn sa.

A. phalloides 8. Nhm Gy kch thch bao t v ng rut: Mt s loi nm thuc cc chi Agaricus, Amanita, Chlorophyllum, Tricholoma gy tiu ha kh chu ch sau 30 n 90 pht n nm. Ph bin nht l nn ma v tiu chy, bng b co tht. Bnh phc trong ngy hoc sau vi ngy. Kh iu tr do khng th xc nh cht c no gy ra triu chng trn v ch bnh phc khi bao t c sc ra sch. Hu ht cc nm c u mc hoang bi c, ven ng, trong rng. C loi c mu trng mut, xm, nu hay sc s. i vi nhng loi thuc chi Amanita u c vng bao cung v bao gc. y l nhng loi nm cng sinh, ch mc chung quanh mt s cy nht nh, r ln vo ma ma hoc trong rng thng xanh. Nhng v ng c nm hoang l do lm ln gia nm n c v nm c cng nh n nhiu vo mt lc. Th d nh: Amanita phalloides c mu trng, mm, mi rt du nh mt ong. Khi nu thm mi ht d, 90% trng hp gy cht chu u, chu M l do loi nm ny. Amanita verna: mc vng nhit i, gy cht ngi nhiu Vit Nam, v d nh la do c mu trng mut, p. X. Hi chng D dy rut xut v suy Amanita phalloide, A. ocreta, A verna, A Galerina autumnalis, Amatoxxin Xut hin mun sau n t 6 n 24 gi. Kch thch d dy rut Bng phn loi nm c Loi nm c t Triu chng

hin mun virosa, A bisporigena,

gan

G marginata v mt vi loi Lepiota v Conocybe

nh nn, a chy, au bng co tht, sau cp, cp. 2-3 hoc ngy ti xut hin suy gan

D dy rut xut hin mun, bt thng v thn kinh trung ng, tan mu, vim gan

Gyrometra (helvella)Monomethylhydrazine Hi chng kch esculanta, loi khc thch d dy rut xut hin mun sau n t 6-12 gi. Biu nn, u, sng, tamn a yu co hin chy, c, git, mu,

chng mt, au

methemoglobin, c th gp suy gan thn. HC c Clitocybe dealbata, CMuscarin Inocybe, Omphalotus olearius Sau n 30 pht-2 gi,V m hi, nhp nhanh, co tht ph qun, chy nc mt, tng tit nc bt, nn, a chy, ng t co. iu cholinergi cerusata, hoc suy

tr bng Atropin.

Phn ng Coprinus ging vi ru atramentarius, Dislfiram Clitocybe clavipes

Coprine

Trong vng 30 pht nn, bng, sau nn, khi nhp ung ru: bun

nhanh, tt huyt p, nguy c xy ra phn ng c th ti 5 ngy su n nm. HC khng Amanita muscaria, AAxit cholinergi pantheria c muscimol Iboteric,Sau n 30 pht-2 gi, Nn, chng mt, hoang sng, Vim dy d Amanita smithiana v Allenic norleucine ri tm thn. au bng, nn xy ra sau n 30 pht - 12 gi, suy thn tin trin t t vo ngy th 2-3. Cn vim Cortinarius orellanus, orellanine d dy mun v suy thn loi Cortinarius khc au bng, chn n, nn xy ra sau 24-36 gi, sau xut hin git c, lon tng,

suy thn

suy thn t ngy th 3 n 14 ngy o gic Psilocybe khc cubensis,Psilocybin, psilocyn (hoi t ng thn) Sau n 30 pht-2 gi, o gic, ri lon cm gic, nhp nhanh, ng t gin, c th co git. Kch thch Chlorophyllum d rut Thiu mu mu tan dy molybdite, Boteus Khng xc nh satanas, loi khc Paxillus involutus Khng xc nh Nn, a chy xut hin 30 pht - 2 gi sau n Triu chng kch thch d dy rut, xut mu hin do tan trung Panaeolina foenisecii,

gian min dch sau n 2 gi XI. C ch gy c nm Amanita nc ta a s cc v ng c v nm la do nm Amanita, sau y l c ch gy c nm Amanita Amanitin c cu to gm mt nhm cyclic polypeptides phc tp m lm tn hi m tng hp RNA, ngn cn vic sn xut c th ca protein trong cc t bo gan v thn. Amatoxins tn cng cc nucleoli trong nuclei ca cc t bo gan. C ch ng c chia lm 4 giai on 1. Giai on u (tim tng):
Thi gian 6 n 24 gi sau khi n ,cc c t s tch ly trong gan

v thn.

2. Giai on th hai: Khong thi gian khong 24 gi tip theo c trng ca lc nn ma, tiu chy. 3. Giai on th ba: Khong thi gian 24 gi n 4 ngy gan thn v ang b h hng 4. Giai on th t (giai on lp li ) Trong thn v gan xy ra hin tng vng da, d dy v rut b chy mu, dn n t vong t 4-7 ngy sau khi n phi nm c. XII. Cch phn bit nm c v nm thng
NHN DNG HNH THI BN NGOI :

Nm c thng c bao gc ( kiu loa )

Nm c thng c vng cung ( vnh, nhn) cung nm

Nm c thng c nhng m sn xi, nhiu loi mu sc trn phin nm.

 Khi i ly nm, cc bn nn:

- Nn i vi ngi c kinh nghim trong vic thu lm nm - Ghi nh nhng ni c mi trng thun li m nm thng mc, cng vi thi tit khi nm mc. (Nm ch mc trong mi trng v thi tit thch hp mt khong thi gian nht nh.) - Nm c th mc lin tip nhiu ngy cng mt a im. Nm sau, vo ng thi im, nm c th mc li ch c. - Khng nn ct ngang chn nm, phi o ln xem c bc loa hnh chn khng. - Khng nn ly nhng cy nm mc di t m pha di m c cc bo t li ti mu hng. - Khng nn ly nhng nm kha c nha trng c nh sa. - Khng nn ly nm c u bng lng, c mu sc s hay pht sng (ln tinh) trong m ti. - Khng nn n cc loi nm cha r ngun gc v khng bit r nm c n c khng
Khi b ng c nm lp tc gy nn cho cht c c tng ra

ngoi, ung than hot tnh than hp ph cht c trn b mt, ung mt s thuc c tc dung gii c nh rau m, nc ng, ru ngtuyt khng c ung ru v ru l dung mi ha tan rt tt cc cht c v th khng c ung ru khi bi trng c.

TI LIU THAM KHO

1. V Vn nh (2000), Ng c cp nm c, Cm nang cp cu, Nh xut bn Y hc, 370-373. 2. p:// http://en.wikipedia.org/wiki/Amanita_virosa 3. vietbao.vn/Suc-khoe/Xu-tri-khi-ngo-doc-nam/40060092/250/ 4.http://www.khoahoc.com.vn/khampha/sinh-vat-hoc/426_Nam-doc-lanam-co-doc-to.aspx 5. Gio trnh Nm hc ca PGS.TS Ng Anh 6.th vin bi ging violet Nm c 7. Sch cy c Vit Nam-Trn cng Khnh v Phm Hi 8. google.com.vn hnh nh 9. http://en.wikipedia.org/wiki/Amanita_phalloides 10.http://yduocvn.com/? x/=newsdetail&n=3604&/c/=108&/g/=1&/30/4/2010/chan-doan-xu-tringo-doc-cap-do-nam.html

Bi tiu lun

MT S LOI NM C PH BIN

GV HNG DN: TS Ng Anh

SV THC HIN: Nguyn Quc Thanh Lp sinh K32 DHKH HU