Kozer Eran, Barr Joseph, Bulkowstein Mordechai, Avgil Meytal, Greenberg Revital, Matias Atalica, Petrov Irena, Berkovitch Matitiahu
Department of Pediatric Emergency Medicine, Assaf Harofeh Medical Center, Tel-Aviv University, Israel.
Vet Hum Toxicol. 2002 Apr;44(2):106-9.
Repeated doses of acetaminophen given for therapeutic reasons have been reported to cause hepatotoxicity in adults and children. We studied the effect of repeated acetaminophen (APAP) overdoses administered for therapeutic purposes in a prospective cohort of children. Forty-four children, aged 2 mo to 10 y were referred with a fever of >38.5 C for more than 48 h, and received >60 mg APAP/kg/d. In each patient AST, ALT and APAP blood levels were measured. The mean total daily dose of APAP was 92+/-26 (63-171) mg/kg. There was a weak, but significant, negative correlation between age and daily dose of APAP where younger children received higher doses of APAP. In 4 children (9.1%) an elevation of AST and ALT was found. Three of the 4 patients with elevated liver enzymes had received >90 mg APAP/kg/day; APAP blood levels ranged from 0 to 23 mg/mL. No correlation was found between the time since last APAP dose and the serum drug level. Ill children receiving repeated supratherapeutic doses of acetaminophen may show abnormalities in liver function. However, severe liver injury was rare.
据报道，出于治疗目的多次服用对乙酰氨基酚会在成人和儿童中导致肝毒性。我们在一组前瞻性儿童队列中研究了出于治疗目的多次过量服用对乙酰氨基酚（APAP）的影响。44名年龄在2个月至10岁的儿童因体温高于38.5摄氏度且持续超过48小时而前来就诊，他们接受的对乙酰氨基酚剂量超过60毫克/千克/天。对每位患者测量了AST、ALT和对乙酰氨基酚的血药浓度。对乙酰氨基酚的平均每日总剂量为92±26（63 - 171）毫克/千克。年龄与对乙酰氨基酚每日剂量之间存在微弱但显著的负相关，年龄较小的儿童服用的对乙酰氨基酚剂量更高。在4名儿童（9.1%）中发现AST和ALT升高。4名肝功能酶升高的患者中有3名接受的对乙酰氨基酚剂量超过90毫克/千克/天；对乙酰氨基酚血药浓度范围为0至23毫克/毫升。末次服用对乙酰氨基酚后的时间与血清药物浓度之间未发现相关性。接受多次超治疗剂量对乙酰氨基酚的患病儿童可能会出现肝功能异常。然而，严重肝损伤很少见。
