Lin C M, Lai C P, Fang T C, Lin C L
Department of Internal Medicine, Tzu-Chi Buddhist General Hospital, Hualien, Taiwan.
J Formos Med Assoc. 1999 Oct;98(10):698-700.
We present a case of glyphosate-induced cardiogenic shock in a young man. The patient a 26-year-old man, presented with nausea and vomiting 4 hours after attempting suicide by drinking 150 mL of glyphosate surfactant. Cardiogenic shock with accelerated idio-ventricular rhythm on electrocardiography developed after admission. Intravenous injection of epinephrine, atropine, and calcium failed to improve the condition. Over the next 16 hours, the QRS complex gradually narrowed, sinus rhythm returned, and the hemodynamic status improved. Echocardiograms revealed diffuse left ventricular hypokinesis with markedly reduced ejection fraction while the patient was in shock; normal left ventricular function resumed the next day. In this case, the glyphosate surfactant poisoning-induced shock may have been due to transient suppression of the cardiac conduction system and contractility, rather than intravascular hypovolemia.
我们报告一例年轻男性因草甘膦导致的心源性休克病例。该患者为一名26岁男性，在饮用150毫升草甘膦表面活性剂企图自杀4小时后出现恶心和呕吐。入院后出现心源性休克，心电图显示心室加速性自主心律。静脉注射肾上腺素、阿托品和钙剂未能改善病情。在接下来的16小时内，QRS波群逐渐变窄，窦性心律恢复，血流动力学状态改善。超声心动图显示患者休克时左心室弥漫性运动减弱，射血分数明显降低；次日左心室功能恢复正常。在该病例中，草甘膦表面活性剂中毒所致休克可能是由于心脏传导系统和收缩力的短暂抑制，而非血管内血容量不足。
