Rzepecki Jacek, Krakowiak Anna, Fiszer Marta, Czyzewska Sylwia, Winnicka Renata, Kołaciński Zbigniew, Politański Piotr, Swiderska Sylwia
Oddział Toksykologii, Klinika Chorób Zawodowych i Toksykologii, Instytut Medycyny Pracy w Łodzi.
Przegl Lek. 2012;69(8):431-4.
The main objective of this study was an analysis of the cohort of patients hospitalized due to intoxication with this agent during the period 2000-2009 and investigate factors, which determined the course of poisoning. During the search process, 288 (1.07%) patients were identified within total number of 26801 patients hospitalized. Within analysed cohort male patients formed majority with 227 males, whereas only 61 females were found within this group. The mean methanol blood concentration was 50.09 mg/dl and ethanol - 292.90 mg/dl. Patients condition on admission varied, the most frequently noted pathologies were consciousseness disturbances and tachycardia, namely the former was recorded in 171 cases (59.4%) whereas the latter in 89 patients (30.90%). 11 patients died within the analysed group and 72 developed single or multiorgan complications in the course of poisoning. The most commonly encountered complication was pneumonia. Features of central nervous system (CNS) damage were found in 20 cases (6.94%). Average concentrations of methanol in the group of the 11 deceased patients were: 158.73 mg/ dl, 20.91 mg/dl for ethanol. The average values of arterial blood gases parameters in this group were pH= 6.98; BE=(-) 22.482; HCO3=9.67 mmol/l. Within the non survivors group such complications as CNS damage, seizures, pneumonia, liver injury and pancreatitis were noted more frequently, with statistical significance. The concentrations of methanol and ethanol in the blood on admission and such ABG parameters as pH, BE, HCO3, pCO2 i pO2 also measured on admission should be considered as the prognostic factors, determining the course of the disease and the outcomes of treatment. Poor prognosis may be associated with such clinical features on admission, as: respiratory and circulatory disturbances and cerebral sequelae.
本研究的主要目的是分析2000年至2009年期间因该药物中毒而住院的患者队列,并调查决定中毒病程的因素。在搜索过程中,在总共26801名住院患者中确定了288名(1.07%)患者。在分析的队列中,男性患者占多数,有227名男性,而该组中仅发现61名女性。甲醇血液平均浓度为50.09mg/dl,乙醇为292.90mg/dl。入院时患者的状况各不相同,最常出现的病症是意识障碍和心动过速,前者记录在171例(59.4%)中,后者记录在89例(30.90%)中。分析组中有11名患者死亡,72名患者在中毒过程中出现单一或多器官并发症。最常见的并发症是肺炎。在20例(6.94%)中发现了中枢神经系统(CNS)损伤的特征。11名死亡患者组中的甲醇平均浓度为:158.73mg/dl,乙醇为20.91mg/dl。该组动脉血气参数的平均值为pH = 6.98;BE =(-)22.482;HCO3 = 9.67mmol/l。在非存活者组中,CNS损伤、癫痫发作、肺炎、肝损伤和胰腺炎等并发症更频繁出现,具有统计学意义。入院时血液中的甲醇和乙醇浓度以及入院时也测量的ABG参数如pH、BE、HCO3、pCO2和pO2应被视为决定疾病病程和治疗结果的预后因素。预后不良可能与入院时的此类临床特征有关,如:呼吸和循环障碍以及脑后遗症。