Beer C, Pakravan N, Hudson M, Smith L T, Simpson K, Bateman D N, Thomas S H L
Wolfson Unit of Clinical Pharmacology, School of Clinical and Laboratory Sciences, University of Newcastle, Newcastle upon Tyne NE2 4HH.
QJM. 2007 Feb;100(2):93-6. doi: 10.1093/qjmed/hcm003. Epub 2007 Jan 20.
It has been suggested that current UK thresholds for treating paracetamol overdose should be reduced, following case reports of patients developing fatal liver failure after presenting with paracetamol concentrations below these thresholds.
To determine the frequency of severe liver dysfunction following paracetamol overdose when paracetamol concentrations are below current UK antidote thresholds.
Retrospective case note review.
Details were collected from all patients admitted to liver transplant units in Newcastle and Edinburgh with paracetamol-induced hepatotoxicity.
Of 696 patients admitted to the two liver units following paracetamol overdose, 14 presented between 4 and 15 h after overdose with paracetamol concentrations below current UK treatment thresholds (estimated annual population rate 0.15/million person-years). Over the period of study, >100 000 presentations with paracetamol overdose would be expected in the catchment populations for these liver units.
In view of the rarity of this event, this research does not suggest a need to lower the current thresholds for antidotal treatment.
有病例报告称，患者在对乙酰氨基酚浓度低于英国现行阈值时出现致命性肝功能衰竭，因此有人建议降低英国目前治疗对乙酰氨基酚过量的阈值。
确定对乙酰氨基酚浓度低于英国现行解毒阈值时，对乙酰氨基酚过量后严重肝功能障碍的发生率。
回顾性病例记录审查。
收集所有因对乙酰氨基酚引起的肝毒性而入住纽卡斯尔和爱丁堡肝移植单位的患者的详细信息。
在696例因对乙酰氨基酚过量而入住这两个肝移植单位的患者中，有14例在过量服用后4至15小时出现对乙酰氨基酚浓度低于英国现行治疗阈值（估计年人口发生率为0.15/百万人口年）。在研究期间，预计这些肝移植单位的服务人群中会有超过100000例对乙酰氨基酚过量就诊病例。
鉴于该事件的罕见性，本研究并不建议降低目前的解毒治疗阈值。
