McElwee N E, Veltri J C, Bradford D C, Rollins D E
Intermountain Regional Poison Control Center, Salt Lake City, Utah 84132.
Ann Emerg Med. 1990 Jun;19(6):657-62. doi: 10.1016/s0196-0644(05)82471-0.
The availability of ibuprofen without a prescription requires assessment of its acute toxicity in the general population. We report results from a prospective study of 329 cases of ibuprofen overdose from a statewide cohort that were reported to our poison center between April 1985 and November 1986; 85 patients had ibuprofen serum concentrations measured. Gastrointestinal disturbances and central nervous system depression were the most common clinical findings (42% and 30% of patients, respectively), but the severity was mild; only one patient had severe symptoms that could be attributed to ibuprofen. Ibuprofen serum concentrations correlated poorly with gastrointestinal symptoms (r = -.177), central nervous system findings (r = .176), presence of coingestants (r = .078), and presence of potentially life-threatening symptoms (r = .087). We evaluated the usefulness of a previously published nomogram to predict ibuprofen toxicity; the positive predictive value for severe symptoms was 6% for all patients and 0% for patients ingesting ibuprofen alone. We conclude that the frequency of life-threatening complications from ibuprofen overdose is low, the nomogram is not predictive of toxicity, and routine serum concentration determinations are not useful as an adjunct in the management of overdose cases.
布洛芬无需处方即可获取，这就需要评估其在普通人群中的急性毒性。我们报告了一项前瞻性研究的结果，该研究涉及1985年4月至1986年11月间向我们毒物中心报告的全州范围内329例布洛芬过量病例；85例患者检测了布洛芬血清浓度。胃肠道紊乱和中枢神经系统抑制是最常见的临床表现（分别占患者的42%和30%），但严重程度较轻；只有1例患者出现了可归因于布洛芬的严重症状。布洛芬血清浓度与胃肠道症状（r = -0.177）、中枢神经系统表现（r = 0.176）、合并摄入其他物质的情况（r = 0.078）以及存在潜在危及生命症状（r = 0.087）之间的相关性较差。我们评估了先前发表的列线图预测布洛芬毒性的效用；所有患者中严重症状的阳性预测值为6%，单独服用布洛芬的患者为0%。我们得出结论，布洛芬过量导致危及生命并发症的频率较低，列线图无法预测毒性，常规血清浓度测定作为过量病例管理的辅助手段并无用处。
