Latus Joerg, Kimmel Martin, Alscher Mark Dominik, Braun Niko
Department of Internal Medicine, Division of Nephrology, Robert-Bosch Hospital, Stuttgart, Germany.
Clin Kidney J. 2012 Apr;5(2):120-3. doi: 10.1093/ckj/sfs009.
Intoxication with ethylene glycol happen all around the world and without rapid recognition and early treatment, mortality from this is high.
In our study, we retrospectively analysed six cases of ethylene glycol intoxication in our department. We measured ethylene glycol or glycolate levels, lactate levels and calculated the osmolal and anion gap.
Data from six patients admitted to the nephrology department between 1999 and 2011 with ethylene glycol poisoning are reported. All patients were men. The mean pH on admission was 7.15 ± 0.20 and the anion and osmolal gap were elevated in five of six patients. Four patients had an acute kidney injury and one patient had an acute-on-chronic kidney injury. All patients survived and after being discharged, two patients required chronic intermittent haemodialysis. Interestingly, at the time of admission, all patients had elevated lactate levels but there was no linear regression between toxic levels and lactate levels and no linear correlation was found between initial lactate levels and anion gap and osmolal gap.
The initial diagnosis of ethylene glycol poisoning is difficult and poisoning with ethylene glycol is rare but life threatening and needs rapid recognition and early treatment. Therefore, intoxication with ethylene glycol should not be misdiagnosed as lactic acidosis in patients with metabolic acidosis and elevated lactate levels.
乙二醇中毒在全球范围内均有发生，若不能迅速识别并尽早治疗，死亡率很高。
在我们的研究中，我们回顾性分析了我科6例乙二醇中毒病例。我们测量了乙二醇或乙醇酸水平、乳酸水平，并计算了渗透压和阴离子间隙。
报告了1999年至2011年间收治于肾内科的6例乙二醇中毒患者的数据。所有患者均为男性。入院时平均pH值为7.15±0.20，6例患者中有5例阴离子间隙和渗透压升高。4例患者发生急性肾损伤，1例患者发生慢性肾脏病急性损伤。所有患者均存活，出院后，2例患者需要进行慢性间歇性血液透析。有趣的是，入院时所有患者乳酸水平均升高，但中毒水平与乳酸水平之间无线性回归，初始乳酸水平与阴离子间隙和渗透压间隙之间也无线性相关性。
乙二醇中毒的初始诊断困难，乙二醇中毒虽罕见但危及生命，需要迅速识别并尽早治疗。因此，对于代谢性酸中毒且乳酸水平升高的患者，不应将乙二醇中毒误诊为乳酸性酸中毒。
