Kim Dongseob, Moon Jeongmi, Chun Byeongjo
Department of Emergency Medicine, Chonnam National University Medical School, Gwangju, Korea.
J Korean Med Sci. 2015 Apr;30(4):365-70. doi: 10.3346/jkms.2015.30.4.365. Epub 2015 Mar 19.
This retrospective observational case series study was conducted to describe the clinical feature of acute type II pyrethroid poisoning, and to investigate whether hyperglycemia at presentation can predict the outcome in patients with type II pyrethroid poisoning. This study included 104 type II pyrethroid poisoned patients. The complication rate and mortality rate was 26.9% and 2.9% in type II pyrethroid poisoned patients. The most common complication was respiratory failure followed by acidosis and hypotension. In non-diabetic type II pyrethroid poisoned patients, patients with complications showed a higher frequency of hyperglycemia, abnormalities on the initial X ray, depressed mentality, lower PaCO2 and HCO3- levels, and a higher WBC and AST levels at the time of admission compared to patients without complication. Hyperglycemia was an independent factor for predicting complications in non-diabetic patients. Diabetic patients had a significantly higher incidence of complications than non-diabetic patients. However, there was no significant predictive factor for complications in patients with diabetes mellitus probably because of small number of diabetes mellitus. In contrast to the relatively low toxicity of pyrethroids in mammals, type II pyrethroid poisoning is not a mild disease. Hyperglycemia at presentation may be useful to predict the critical complications in non-diabetic patients.
本回顾性观察性病例系列研究旨在描述急性II型拟除虫菊酯中毒的临床特征，并探讨就诊时的高血糖是否可预测II型拟除虫菊酯中毒患者的预后。本研究纳入了104例II型拟除虫菊酯中毒患者。II型拟除虫菊酯中毒患者的并发症发生率和死亡率分别为26.9%和2.9%。最常见的并发症是呼吸衰竭，其次是酸中毒和低血压。在非糖尿病II型拟除虫菊酯中毒患者中，与无并发症患者相比，有并发症的患者在入院时出现高血糖、初始X线异常、意识障碍、较低的PaCO2和HCO3-水平以及较高的白细胞和谷草转氨酶水平的频率更高。高血糖是预测非糖尿病患者并发症的独立因素。糖尿病患者的并发症发生率明显高于非糖尿病患者。然而，糖尿病患者并发症的预测因素不显著，可能是因为糖尿病患者数量较少。与拟除虫菊酯在哺乳动物中相对较低的毒性相反，II型拟除虫菊酯中毒并非轻症疾病。就诊时的高血糖可能有助于预测非糖尿病患者的严重并发症。
