Janus Tomasz, Borowiak Krzysztof S, Pabisiak Krzysztof, Machoy-Mokrzyńska Anna, Swiniarski Andrzej, Rozwadowski Zbigniew
Department of Forensic Medicine, Clinical Toxicology Division, Pomeranian University of Medicine, Powstancow Wlkp. 72, 70-11 Szczecin, Poland.
Basic Clin Pharmacol Toxicol. 2005 Oct;97(4):257-60. doi: 10.1111/j.1742-7843.2005.pto_154.x.
Occasional or suicidal methanol intoxications are a permanent problem for most Poisoning Centers around the World. Therefore it is important to look for new diagnostic and clinical prognostic methods. In the present paper 5 cases of methanol intoxication were analyzed. At first the methanol concentrations in blood and urine were estimated with headspace gas chromatography technique. Next the urine samples were examined with 1H NMR spectroscopy, then the levels of ethanol, methanol and its metabolite, formate, lactate and trimethylamine-N-oxide with dimethylamine were evaluated. The concentrations of the above compounds were correlated with the patient's clinical status, the level of ethanol and methanol and biochemical parameters. The results indicate the correlation between clinical course of intoxication, prognostication and lactate level. There were no significant parallels for formate level as acidosis causing metabolite and initial methanol levels. In the urine samples of intoxicated patients the increased trimethyl-N-oxide and dimethylamine levels were observed, which may indicate renal cortex damage. Contrary to the opinion of some clinicians, methanol intoxication may be connected with renal functional disturbances. 1H NMR examination of urine appears to be an excellent tool to evaluate the clinical course of methanol intoxication.
偶尔发生的或自杀性的甲醇中毒，对于全球大多数中毒控制中心来说都是一个长期存在的问题。因此，寻找新的诊断和临床预后方法很重要。本文分析了5例甲醇中毒病例。首先，采用顶空气相色谱技术测定血液和尿液中的甲醇浓度。接着，用1H核磁共振波谱法检测尿液样本，然后评估乙醇、甲醇及其代谢产物甲酸、乳酸以及三甲胺 - N - 氧化物与二甲胺的水平。上述化合物的浓度与患者的临床状况、乙醇和甲醇水平以及生化参数相关。结果表明中毒的临床过程、预后与乳酸水平之间存在相关性。作为引起酸中毒的代谢产物，甲酸水平与初始甲醇水平之间没有显著的平行关系。在中毒患者的尿液样本中，观察到三甲胺 - N - 氧化物和二甲胺水平升高，这可能表明肾皮质受损。与一些临床医生的观点相反，甲醇中毒可能与肾功能紊乱有关。尿液的1H核磁共振检查似乎是评估甲醇中毒临床过程的一个极好工具。
