Graudins Andis
Monash Health Clinical Toxicology and Addiction Medicine Service, Monash Emergency Medicine Program, Monash Dandenong Hospital, Monash Health, Melbourne, Victoria, Australia; School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia.
Emerg Med Australas. 2015 Apr;27(2):139-44. doi: 10.1111/1742-6723.12373. Epub 2015 Mar 5.
To describe and compare the characteristics of paracetamol poisoning in adolescent and adult patients.
Descriptive retrospective case series of adolescent (12-17 years) and adult (>18 years) patients presenting to a metropolitan hospital network ED, diagnosed with paracetamol poisoning from October 2009 to September 2013.
There were 220 adolescent (median age 16 years, 47% treated with acetylcysteine [NAC]) and 647 adult presentations (median age 27 years, 42% treated with NAC) for paracetamol poisoning in the study period. Adolescent patients were more frequently women (89% vs 76%; odds ratio [OR] 2.4; 95% confidence interval [CI] 1.5-3.8) and ingested similar amounts of paracetamol (18 g) when requiring NAC treatment. Adolescents were more likely to ingest paracetamol as a single agent (53% vs 34%; OR 2.2; 95% CI 1.6-3.0) and less likely to ingest compound paracetamol products than adults (18% vs 29%; OR 0.54; 95% CI 0.36-0.79). Adolescents were less likely to report accidental supratherapeutic ingestion of paracetamol (0.02% vs 10%; OR 0.23; 95% CI 0.09-0.58), or co-ingestion of prescription medications (25% vs 43%; OR 0.4; 95% CI 0.31-0.62). Adolescents had more frequent histamine release reactions to NAC than adults (17% vs 8%; OR 2.3; 95% CI 1.2-4.5). No cases required liver transplantation or resulted in death.
Adolescents ingested comparable amounts of paracetamol to adults, when presenting with deliberate self-poisoning. However, there were significant differences in co-ingested medications and the reason for ingestion of paracetamol. Histamine reactions to NAC were more common in adolescents; however, most were mild. Overall, outcome was favourable in both cohorts.
描述并比较青少年和成年扑热息痛中毒患者的特征。
对2009年10月至2013年9月期间在一家大都市医院网络急诊科就诊、被诊断为扑热息痛中毒的青少年（12 - 17岁）和成年（>18岁）患者进行描述性回顾性病例系列研究。
在研究期间，有220例青少年扑热息痛中毒患者（中位年龄16岁，47%接受乙酰半胱氨酸[NAC]治疗）以及647例成年患者（中位年龄27岁，42%接受NAC治疗）。青少年患者中女性更为常见（89%对76%；优势比[OR]2.4；95%置信区间[CI]1.5 - 3.8），在需要NAC治疗时摄入的扑热息痛量相似（18克）。青少年更倾向于单独摄入扑热息痛（53%对3俯%；OR 2.2；95% CI 1.6 - 3.0），与成年人相比，摄入复方扑热息痛产品的可能性较小（18%对29%；OR 0.54；95% CI 0.36 - 0.79）。青少年报告意外超治疗剂量摄入扑热息痛的可能性较小（0.02%对10%；OR 0.23；95% CI 0.09 - 0.58），同时摄入处方药的可能性也较小（25%对43%；OR 0.4；95% CI 0.31 - 0.62）。青少年对NAC发生组胺释放反应的频率高于成年人（17%对8%；OR 2.3；95% CI 1.2 - 4.5）。无一例患者需要肝移植或导致死亡。
青少年在蓄意自我中毒时摄入的扑热息痛量与成年人相当。然而，同时摄入的药物以及摄入扑热息痛的原因存在显著差异。青少年对NAC的组胺反应更为常见；不过，大多数反应较轻。总体而言，两个队列的结局均良好。
