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磷化铝中毒患者血液中高铁血红蛋白水平及其与患者预后的相关性。

Blood levels of methemoglobin in patients with aluminum phosphide poisoning and its correlation with patient's outcome.

机构信息

Department of Medical Toxicology and Forensic Medicine, Loghman Hakim Poison Hospital, Shaheed Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

J Med Toxicol. 2011 Mar;7(1):40-3. doi: 10.1007/s13181-010-0121-7.

Abstract

Although methemoglobinemia following aluminum phosphide (AlP) intoxication has been reported, probable effect of blood level of methemoglobin (Met-Hb) on outcome of AlP-poisoned patients has not yet been investigated. This study aimed to evaluate blood levels of methemoglobin in patients with AP intoxication and its correlation with patient's outcome. This prospective study was carried out at the Loghman-Hakim poison hospital from April 2009 to August 2009. All patients aged >12 years who had ingested AlP and were admitted at the hospital were enrolled in the study. Using the co-oximetry, blood Met-Hb level was measured at the time of admission and 24 h later if the patient survived. Forty-eight patients with AlP intoxication including 24 males were evaluated. Mean age of the patients was 25.5±9.5 years. There was significant association between blood level of Met-Hb at the time of admission and mortality (2.4%±7.1% in survivors versus 15.2%±13.5% in non-survivors, P<0.001). The same association was found at the 2nd day of admission (2.9%±8.2% in survivors versus 26.5%±9.9% in non-survivors, P=0.02). The present study found an association between blood level of Met-Hb and mortality in patients with AlP intoxication. Effect of administration of vitamin C and methylene blue on outcome of patients with AlP intoxication should be investigated in future studies.

摘要

虽然已有关于磷化铝(AlP)中毒导致高铁血红蛋白血症的报道,但高铁血红蛋白(Met-Hb)血浓度对 AlP 中毒患者预后的可能影响尚未得到研究。本研究旨在评估 AlP 中毒患者的高铁血红蛋白血浓度及其与患者预后的相关性。这是一项前瞻性研究,于 2009 年 4 月至 2009 年 8 月在 Loghman-Hakim 中毒医院进行。所有年龄>12 岁、摄入 AlP 并住院的患者均纳入本研究。使用比色法,在入院时和如果患者存活则在 24 小时后测量血液 Met-Hb 水平。评估了 48 例 AlP 中毒患者,其中 24 例为男性。患者的平均年龄为 25.5±9.5 岁。入院时和第 2 天的血 Met-Hb 水平与死亡率之间存在显著相关性(幸存者为 2.4%±7.1%,而非幸存者为 15.2%±13.5%,P<0.001)。入院时和第 2 天的血 Met-Hb 水平与死亡率之间存在显著相关性(幸存者为 2.4%±7.1%,而非幸存者为 15.2%±13.5%,P<0.001)。在本研究中发现,AlP 中毒患者的血 Met-Hb 水平与死亡率之间存在相关性。未来的研究应调查维生素 C 和亚甲蓝对 AlP 中毒患者预后的影响。

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