Ford Jonathan B, Wayment Mac T, Albertson Timothy E, Owen Kelly P, Radke Joshua B, Sutter Mark E
Department of Emergency Medicine, School of Medicine, University of California, Davis, 4150 V Street, PSSB 2100, Sacramento, CA 95817, USA.
Department of Pediatrics, School of Medicine, University of California, Davis, 2516 Stockton Boulevard, Suite 221, Sacramento, CA 95817, USA.
Case Rep Med. 2013;2013:250716. doi: 10.1155/2013/250716. Epub 2013 Dec 4.
Primary ethanol metabolism occurs through alcohol dehydrogenase, but minor metabolic pathways such as the P450 enzymes CYP2E1 and CYP1A2 and the enzyme catalase exist. These enzymes have distinct developmental stages. Elimination kinetics of ethanol in the infant is limited. We report the elimination kinetics of ethanol in a 5-week-old African-American male who had a serum ethanol level of 270 mg/dL on admission. A previously healthy 5-week-old African-American male was brought to the ED with a decreased level of consciousness. His initial blood ethanol level was 270 mg/dL. Serial blood ethanol levels were obtained. The elimination rate of ethanol was calculated to be in a range from 17.1 to 21.2 mg/dL/hr and appeared to follow zero-order elimination kinetics with a R (2) = 0.9787. Elimination kinetics for ethanol in the young infant has been reported in only four previously published reports. After reviewing these reports, there appears to be variability in the elimination rates of ethanol in infants. Very young infants may not eliminate ethanol as quickly as previously described. Given that there are different stages of enzyme development in children, caution should be used when generalizing the elimination kinetics in young infants and children.
乙醇的主要代谢途径是通过乙醇脱氢酶，但也存在诸如细胞色素P450酶CYP2E1和CYP1A2以及过氧化氢酶等次要代谢途径。这些酶具有不同的发育阶段。婴儿体内乙醇的消除动力学有限。我们报告了一名5周大非裔美国男性的乙醇消除动力学情况，该男性入院时血清乙醇水平为270mg/dL。一名此前健康的5周大非裔美国男性因意识水平下降被送往急诊科。他最初的血液乙醇水平为270mg/dL。获取了系列血液乙醇水平数据。计算得出乙醇的消除速率在17.1至21.2mg/dL/小时范围内，并且似乎遵循零级消除动力学，R² = 0.9787。关于幼儿乙醇消除动力学的报告此前仅发表过4篇。在查阅这些报告后，婴儿乙醇消除速率似乎存在差异。非常年幼的婴儿可能无法像此前描述的那样快速消除乙醇。鉴于儿童酶的发育存在不同阶段，在归纳幼儿和儿童的消除动力学时应谨慎。
