Hong Guangliang, Hu Lufeng, Tang Yahui, Zhang Tao, Kang Xiaowen, Zhao Guangju, Lu Zhongqiu
Department of Emergency, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China.
Department of Pharmacy, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, China.
J Pharmacol Toxicol Methods. 2016 Jul-Aug;80:75-81. doi: 10.1016/j.vascn.2016.05.010. Epub 2016 May 20.
Paraquat (PQ) has caused deaths of numerous people around the world. In order to assess the lethal plasma concentration, the patients who acquired acute PQ intoxication were analyzed by plasma concentration monitoring. The plasma PQ concentrations were determined by high performance liquid chromatography (HPLC) which used 5-bromopyrimidine as internal standard and trichloroacetic acid-methanol (1:9) as protein precipitant. The liver, kidney and coagulation function were determined by automatic biochemical analyzer. According to plasma PQ concentration, 90 patients were divided into four groups: trace PQ group (<50ng/mL), low PQ group (<1000ng/mL), medium PQ group (1000-5000ng/mL) and high PQ group (>5000ng/mL). The clinical data from the four groups was statistically analyzed. The results showed the developed HPLC methods exhibited a high degree of accuracy and good linearity within 50-25000ng/mL (R=0.9998). The Spearman's correlation analysis showed PQ concentration had a strong relationship to total bilirubin, direct bilirubin, aspartic transaminase, urea nitrogen, prothrombin time, prothrombin activity, and international normalized ratio (P<0.01). The cured or survival PQ poisoned patients among the trace PQ group, the low PQ group, the medium PQ group, and the high PQ group were 19/19 (100%), 19/21 (90.47%), 11/25 (44.0%), and 0/25 (0%) respectively. The mean hospital days were (10.37±8.04), (18.76±12.06), (16.76±14.44), and (4.04±5.41) days respectively. The Cox regression analysis indicated that plasma PQ concentration was highly related to prognosis (P<0.05). In conclusion, no patient presenting with a PQ concentration over 5000ng/mL survived. The plasma PQ level is related to liver, kidney and coagulation function, which can be used as an important clinical index to judge the prognosis of PQ poisoned patients.
Paraquat (PubChem CID: 15938), 5-bromopyrimidine (PubChem CID: 78344), acetonitrile (PubChem CID: 6342), sodium dihydrogen phosphate (PubChem CID: 23672064), sodium heptanesulfonate (PubChem CID: 23672332), methylprednisolone (PubChem CID: 6741), cyclophosphamide (PubChem CID: 2907).
百草枯（PQ）已导致全球众多人死亡。为评估致死血浆浓度，对急性PQ中毒患者进行血浆浓度监测分析。采用以5-溴嘧啶为内标、三氯乙酸 - 甲醇（1:9）为蛋白沉淀剂的高效液相色谱法（HPLC）测定血浆PQ浓度。用自动生化分析仪测定肝、肾及凝血功能。根据血浆PQ浓度，将90例患者分为四组：微量PQ组（<50ng/mL）、低PQ组（<1000ng/mL）、中PQ组（1000 - 5000ng/mL）和高PQ组（>5000ng/mL）。对四组临床资料进行统计学分析。结果表明，所建立的HPLC方法在50 - 25000ng/mL范围内具有高度准确性和良好线性（R = 0.9998）。Spearman相关性分析显示，PQ浓度与总胆红素、直接胆红素、天门冬氨酸转氨酶、尿素氮、凝血酶原时间、凝血酶原活性及国际标准化比值密切相关（P < 0.01）。微量PQ组、低PQ组、中PQ组和高PQ组中治愈或存活的PQ中毒患者分别为19/19（100%）、19/21（90.47%）、11/25（44.0%）和0/25（0%）。平均住院天数分别为（10.37±8.04）、（18.76±12.06）、（16.76±14.44）和（4.04±5.41）天。Cox回归分析表明血浆PQ浓度与预后高度相关（P < 0.05）。总之，血浆PQ浓度超过5000ng/mL的患者无一存活。血浆PQ水平与肝、肾及凝血功能相关，可作为判断PQ中毒患者预后的重要临床指标。
百草枯（PubChem CID：15938）、5-溴嘧啶（PubChem CID：78344）、乙腈（PubChem CID：6342）、磷酸二氢钠（PubChem CID：23672064）、庚烷磺酸钠（PubChem CID：23672332）、甲泼尼龙（PubChem CID：6741）、环磷酰胺（PubChem CID：2907）。
