Kamijo Yoshito, Takai Michiko, Sakamoto Tetsuya
a Emergency Medical Center & Poison Center, Saitama Medical University Hospital , Iruma-gun , Saitama , Japan ;
b Center for Suicide Prevention, National Institute of Mental Health, National Center of Neurology and Psychiatry , Tokyo , Japan ;
Clin Toxicol (Phila). 2016;54(2):147-51. doi: 10.3109/15563650.2015.1121271. Epub 2015 Dec 22.
A multicenter retrospective survey of patients poisoned by herbicides containing glyphosate salts in Japan was conducted to identify differences in symptoms and outcome of poisoning.
Participants were patients who were transported to emergency facilities between October 2006 and March 2014 after consuming herbicides containing glyphosate potassium salt (GlyK(+)) (the K-group) or other glyphosate salts (the O-group). Questionnaires were mailed to 38 emergency facilities that agreed to participate in the study.
Serum potassium levels upon arrival were significantly higher (p < 0.01), and abnormal electrocardiogram findings were significantly more common (p < 0.01) in the K-group (n = 55) than in the O-group (n = 62). Conversely, acute lung injury (ALI) including acute respiratory distress syndrome (ARDS) (p = 0.05) and liver injury (LI) (p < 0.01) were significantly more common during hospitalization in the O-group, although no significant differences in the duration of hospital stay (p = 0.92) or outcomes (p = 0.95) were observed between the two groups.
The ingestion of products containing glyphosate isopropylamine or ammonium salts, and polyoxyethyleneamine (POEA) as a surfactant, can cause severe organ injury. Physicians should note that the ingestion of products containing glyphosate potassium salt and surfactants other than POEA can cause hyperkalemia, potentially leading to fatal arrhythmias or cardiac arrest.
在日本开展了一项针对摄入含草甘膦盐除草剂患者的多中心回顾性调查,以确定中毒症状和结局的差异。
研究对象为2006年10月至2014年3月间因摄入含草甘膦钾盐(GlyK(+))的除草剂(K组)或其他草甘膦盐(O组)后被送往急诊机构的患者。向38家同意参与研究的急诊机构邮寄了调查问卷。
K组(n = 55)到达时的血清钾水平显著更高(p < 0.01),异常心电图表现也显著更常见(p < 0.01),高于O组(n = 62)。相反,O组住院期间急性肺损伤(ALI)包括急性呼吸窘迫综合征(ARDS)(p = 0.05)和肝损伤(LI)(p < 0.01)显著更常见,尽管两组间住院时间(p = 0.92)或结局(p = 0.95)无显著差异。
摄入含有草甘膦异丙胺盐或铵盐以及作为表面活性剂的聚氧乙烯胺(POEA)的产品可导致严重器官损伤。医生应注意,摄入含有草甘膦钾盐和非POEA表面活性剂的产品可导致高钾血症,可能引发致命性心律失常或心脏骤停。