Schmidt Lars E, Knudsen Tore Tveit, Dalhoff Kim, Bendtsen Flemming
Department of Hepatology, Rigshospitalet University Hospital, Blegdamsvej 9, DK-2100, Copenhagen, Denmark.
Lancet. 2002 Oct 12;360(9340):1151-2. doi: 10.1016/S0140-6736(02)11194-9.
Acetylcysteine treatment reduces liver damage after paracetamol overdose, but can affect the prothrombin index, which is used to assess the progress of overdose patients. We aimed to assess retrospectively the effect of intravenous acetylcysteine on the prothrombin index in patients with paracetamol poisoning without signs of hepatocellular injury. Prothrombin index had been recorded before, and serially during, acetylcysteine treatment in 87 patients. After initiation of treatment, prothrombin index decreased (mean 0.33, 95% CI 0.29-0.38) in all patients, and was strongly associated with the start of acetylcysteine infusion. In patients with uncomplicated paracetamol poisoning, a fall in this index might be misinterpreted as a sign of liver failure, leading to prolonged treatment time.
乙酰半胱氨酸治疗可减轻对乙酰氨基酚过量服用后的肝损伤，但会影响用于评估过量服用患者病情进展的凝血酶原指数。我们旨在回顾性评估静脉注射乙酰半胱氨酸对无肝细胞损伤迹象的对乙酰氨基酚中毒患者凝血酶原指数的影响。对87例患者在乙酰半胱氨酸治疗前及治疗期间连续记录凝血酶原指数。治疗开始后，所有患者的凝血酶原指数均下降（平均0.33，95%可信区间0.29 - 0.38），且与乙酰半胱氨酸输注开始密切相关。在无并发症的对乙酰氨基酚中毒患者中，该指数下降可能被误解为肝衰竭的迹象，从而导致治疗时间延长。
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