Hazai E, Monostory K, Bakos A, Zacher G, Vereczkey L
Magyar Tudományos Akadémia, Budapest, Kémiai Kutatóközpont, Farmakobiokémiai Osztály.
Orv Hetil. 2001 Feb 18;142(7):345-9.
The mechanism of hepatotoxicity caused by paracetamol (acetaminophen) overdose and the treatment of patients is reviewed. Paracetamol is widely used over-the-counter drug with analgesic and antipyretic properties. Although it is considered to be safe at therapeutic doses, the incidence of hepatotoxicity caused by overdose or inadvertent application has been increasing lately. N-acetyl-p-benzoquinonimine, one of the metabolites formed from paracetamol is responsible for the hepatotoxicity. Until now there is no complete therapeutic strategy for the effective treatment of hepatotoxicity caused by paracetamol. Gut decontamination, N-acetylcysteine antidote administration and enhancement of elimination is used for the management of paracetamol overdose. Those with severe hepatotoxicity and neurological symptoms can benefit from removal of necrotic liver and undergo transplantation.
本文综述了对乙酰氨基酚（扑热息痛）过量引起肝毒性的机制以及患者的治疗方法。对乙酰氨基酚是一种广泛使用的具有镇痛和解热特性的非处方药。尽管在治疗剂量下被认为是安全的，但近年来因过量服用或误服导致肝毒性的发生率一直在上升。对乙酰氨基酚形成的代谢产物之一N - 乙酰 - 对苯醌亚胺是造成肝毒性的原因。到目前为止，对于对乙酰氨基酚引起的肝毒性尚无完整有效的治疗策略。肠道去污、给予N - 乙酰半胱氨酸解毒剂以及促进排泄用于对乙酰氨基酚过量的处理。那些具有严重肝毒性和神经症状的患者可通过切除坏死肝脏并接受移植而获益。
