Yu Hsin-Ying, Lin Ja-Liang, Fu Jen-Fen, Lin Jui-Hsiang, Liu Shou-Hsuan, Weng Cheng-Hao, Huang Wen-Hung, Chen Kuan-Hsing, Hsu Ching-Wei, Yen Tzung-Hai
Department of Nephrology and Division of Clinical Toxicology, Chang Gung Memorial Hospital, 199 Tung Hwa North Road, Taipei, 105 Taiwan ; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Springerplus. 2013 Oct 3;2:505. doi: 10.1186/2193-1801-2-505. eCollection 2013.
Rodenticide poisoning remains a major public health problem in Asian countries. Nevertheless, very few data are available in world literature regarding the outcomes of these patients. Therefore, the purpose of this study was to investigate the clinical outcomes of rodenticide poisonings in our hospital and to compare these data with published reports from other international poison centers.
We retrospectively examined the records of 20 patients with rodenticide poisoning (8 brodifacoum, 12 bromadiolone) who were referred to Chang Gung Memorial Hospital between 2000 and 2011. It was found that most of the rodenticide patients were middle-aged adults. Both genders were equally affected and many patients had a past history of major depressive disorder or schizophrenia. Nevertheless, patients with bromadiolone were referred significantly sooner than patients with brodifacoum poisoning (0.1 ± 0.1 versus 5.5 ± 10.5, P < 0.001). Furthermore, it was found that patients with brodifacoum suffered higher incidences of ecchymosis (50.0% versus 0%, P = 0.006) and hematuria (50.0% versus 0%, P = 0.006) than patients with bromadiolone poisoning. Laboratory analysis also demonstrated a poorer hemostatic profile of patients with brodifacoum [prothrombin time (PT), international normalized ratio (INR), 4.3 ± 4.8 versus 1.0 ± 0.1, P = 0.032; PT prolongation, 50.0% versus 0%, P = 0.006; activated partial thromboplastin time (aPTT) prolongation, 50.0% versus 0%, P = 0.006] than patients with bromadiolone poisoning. At the end of analysis, no patient died of the poisoning.
The favorable outcome (zero mortality rate) is comparable to the published reports from other international poison centers. Further studies are warranted.
杀鼠剂中毒在亚洲国家仍然是一个主要的公共卫生问题。然而,世界文献中关于这些患者治疗结果的数据非常少。因此,本研究的目的是调查我院杀鼠剂中毒的临床结果,并将这些数据与其他国际中毒控制中心发表的报告进行比较。
我们回顾性检查了2000年至2011年间转诊至长庚纪念医院的20例杀鼠剂中毒患者(8例溴敌隆中毒,12例溴鼠灵中毒)的记录。发现大多数杀鼠剂中毒患者为中年成年人。男女受影响程度相同,许多患者有重度抑郁症或精神分裂症病史。然而,溴鼠灵中毒患者的转诊时间明显早于溴敌隆中毒患者(0.1±0.1天对5.5±10.5天,P<0.001)。此外,发现溴敌隆中毒患者的瘀斑发生率(50.0%对0%,P=0.006)和血尿发生率(50.0%对0%,P=0.006)高于溴鼠灵中毒患者。实验室分析还表明,溴敌隆中毒患者的凝血指标较差[凝血酶原时间(PT)、国际标准化比值(INR),4.3±4.8对1.0±0.1,P=0.032;PT延长,50.0%对零,P=0.006;活化部分凝血活酶时间(aPTT)延长,50.0%对零,P=0.006]。分析结束时,无患者死于中毒。
良好的治疗结果(零死亡率)与其他国际中毒控制中心发表的报告相当。有必要进行进一步的研究。