Wade H, McCoubrie D L, Fatovich D M, Ryan J, Vasikaran S, Daly F F
Royal Perth Hospital, Department of Emergency Medicine, Box X2213 GPO, Perth, 6847 Australia.
Clin Toxicol (Phila). 2008 Jul;46(6):534-8. doi: 10.1080/15563650701666298.
To determine the correlation between plasma and saliva paracetamol levels following paracetamol deliberate self-poisoning.
Paired plasma and saliva paracetamol levels were measured. Saliva analysis was performed contemporaneously using a colorimetric method.
21 patients (76% female) mean age 28.3 +/- 12.9 years (range 15-55) were enrolled. Mean reported paracetamol ingestion was 10.3 g (range 2-20 g). Specimens were collected at a mean of 6.2 +/- 3.1 hours post-ingestion (range 4-13 hours) and mean plasma and saliva paracetamol levels were 48 mg/L and 62 mg/L respectively (mean difference 14; 95% CI 5-22; p < 0.004); Pearson's correlation r = 0.95 (p < 0.0001). No patient needing treatment would have been missed using saliva levels only.
There is concordance between the indications for treatment of paracetamol deliberate self-poisoning based on plasma and saliva paracetamol levels. Saliva paracetamol levels are typically higher than plasma levels. Further studies involving larger numbers of patients, comparing plasma and saliva paracetamol levels in patients with potentially toxic plasma paracetamol concentrations, would be useful in determining the potential clinical value of this method.
确定对乙酰氨基酚蓄意自我中毒后血浆和唾液中对乙酰氨基酚水平之间的相关性。
测量配对的血浆和唾液中对乙酰氨基酚水平。同时采用比色法进行唾液分析。
纳入21例患者（76%为女性），平均年龄28.3±12.9岁（范围15 - 55岁）。报告的对乙酰氨基酚平均摄入量为10.3 g（范围2 - 20 g）。在摄入后平均6.2±3.1小时（范围4 - 13小时）采集样本，血浆和唾液中对乙酰氨基酚的平均水平分别为48 mg/L和62 mg/L（平均差异14；95%可信区间5 - 22；p < 0.004）；Pearson相关系数r = 0.95（p < 0.0001）。仅使用唾液水平不会遗漏任何需要治疗的患者。
基于血浆和唾液中对乙酰氨基酚水平进行对乙酰氨基酚蓄意自我中毒治疗的指征之间具有一致性。唾液中对乙酰氨基酚水平通常高于血浆水平。进一步开展涉及更多患者的研究，比较血浆对乙酰氨基酚浓度可能有毒的患者的血浆和唾液中对乙酰氨基酚水平，将有助于确定该方法的潜在临床价值。
