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[pH值低于6.8的代谢性酸中毒患者有可能存活吗?两例食用工业酒精中毒病例的研究]

[Is it possible to survive metabolic acidosis with pH measure below 6.8? A study of two cases of inedible alcohol intoxication].

作者信息

Kostek Halina, Kujawa Anna, Szponar Jarosław, Danielewicz Piotr, Majewska Magdalena, Drelich Grzegorz

机构信息

Samodzielny Publiczny Szpital Wojewódzki im. Jana Bozego w Lublinie, Regionalny Ośrodek Toksykologii Klinicznej.

出版信息

Przegl Lek. 2011;68(8):518-20.

Abstract

26 of serious inedible alcohol (ethylene glycol and methanol) intoxications have been observed in Lublin Regional Center of Clinical Toxicology during 2010/2011 (18 mounths). As a result of such intoxications, metabolic acidosis and acute renal failure and other organs injury develop. The writings inform that it is possible to survive a pH spectrum between 6.8 and 7.8, whereas beyond these values protein denaturation and death proceed. The paper presents two cases of intoxication with ethylene glycol and ethylene glycol, methanol together where the lowest pH values in capillary blood were recorded below 6.8. The first case is of a male, 45, who was diagnosed glycol concentration at 283.3 mg/dl, with the lowest pH value obtained in the gasometric examination of capillary blood at 6.712. The other case is of another male, 54, who had probably drunk condenser liquid. Ethylene glycol and methanol's concentration were 535 mg/dl and 37.5 mg/dl correspondingly, whereas the lowest capillary blood pH value was recorded at 6.745. Both men had been addicted to alcohol for many years. The treatment demanded multiple hemodialyses, respiratory therapy, catecholamine intravenous injections as well as intensive pharmacological treatment resulting from multi-organ complications. The intoxication in either case was non-lethal.

摘要

2010年至2011年(18个月)期间,卢布林地区临床毒理学中心观察到26例严重的不可食用酒精(乙二醇和甲醇)中毒病例。此类中毒会导致代谢性酸中毒、急性肾衰竭以及其他器官损伤。文献表明,pH值在6.8至7.8之间时有可能存活,而超出这些值则会发生蛋白质变性并导致死亡。本文介绍了两例乙二醇中毒以及乙二醇与甲醇混合中毒的病例,其中毛细血管血中记录到的最低pH值低于6.8。第一例是一名45岁男性,经诊断乙二醇浓度为283.3毫克/分升,在毛细血管血气分析中获得的最低pH值为6.712。另一例是另一名54岁男性,他可能饮用了冷凝液。乙二醇和甲醇的浓度分别为535毫克/分升和37.5毫克/分升,而毛细血管血的最低pH值记录为6.745。两名男性均有多年酗酒史。治疗需要多次血液透析、呼吸治疗、儿茶酚胺静脉注射以及针对多器官并发症的强化药物治疗。两例中毒均未致命。

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