Ehlers Alexandra, Morris Cory, Krasowski Matthew D
Clinical Chemistry Laboratory, Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA 52242 USA.
Springerplus. 2013 May 1;2(1):203. doi: 10.1186/2193-1801-2-203. Print 2013 Dec.
A rapid headspace-gas chromatography (HS-GC) method was developed for the analysis of ethylene glycol and propylene glycol in plasma and serum specimens using 1,3-propanediol as the internal standard. The method employed a single-step derivitization using phenylboronic acid, was linear to 200 mg/dL and had a lower limit of quantitation of 1 mg/dL suitable for clinical analyses. The analytical method described allows for laboratories with HS-GC instrumentation to analyze ethanol, methanol, isopropanol, ethylene glycol, and propylene glycol on a single instrument with rapid switch-over from alcohols to glycols analysis. In addition to the novel HS-GC method, a retrospective analysis of patient specimens containing ethylene glycol and propylene glycol was also described. A total of 36 patients ingested ethylene glycol, including 3 patients who presented with two separate admissions for ethylene glycol toxicity. Laboratory studies on presentation to hospital for these patients showed both osmolal and anion gap in 13 patients, osmolal but not anion gap in 13 patients, anion but not osmolal gap in 8 patients, and 1 patient with neither an osmolal nor anion gap. Acidosis on arterial blood gas was present in 13 cases. Only one fatality was seen; this was a patient with initial serum ethylene glycol concentration of 1282 mg/dL who died on third day of hospitalization. Propylene glycol was common in patients being managed for toxic ingestions, and was often attributed to iatrogenic administration of propylene glycol-containing medications such as activated charcoal and intravenous lorazepam. In six patients, propylene glycol contributed to an abnormally high osmolal gap. The common presence of propylene glycol in hospitalized patients emphasizes the importance of being able to identify both ethylene glycol and propylene glycol by chromatographic methods.
建立了一种快速顶空气相色谱（HS-GC）法，以1,3-丙二醇为内标，用于分析血浆和血清标本中的乙二醇和丙二醇。该方法采用苯硼酸进行一步衍生化，线性范围达200mg/dL，定量下限为1mg/dL，适用于临床分析。所述分析方法使配备HS-GC仪器的实验室能够在同一台仪器上分析乙醇、甲醇、异丙醇、乙二醇和丙二醇，且能从醇类分析快速切换到二醇类分析。除了这种新颖的HS-GC方法外，还描述了对含有乙二醇和丙二醇的患者标本的回顾性分析。共有36例患者摄入乙二醇，其中3例因乙二醇中毒分别入院两次。这些患者入院时的实验室检查显示，13例患者同时存在渗透压和阴离子间隙，13例患者有渗透压但无阴离子间隙，8例患者有阴离子间隙但无渗透压，1例患者既无渗透压也无阴离子间隙。13例患者动脉血气分析显示存在酸中毒。仅1例死亡；该患者初始血清乙二醇浓度为1282mg/dL，住院第三天死亡。丙二醇在中毒患者的治疗中很常见，且常归因于医源性给予含丙二醇的药物，如活性炭和静脉注射劳拉西泮。在6例患者中，丙二醇导致渗透压间隙异常升高。住院患者中丙二醇的普遍存在凸显了通过色谱法同时识别乙二醇和丙二醇的重要性。
