Hodgman Michael, Marraffa Jeanna M, Wojcik Susan, Grant William
Department of Emergency Medicine, Upstate Medical University, Syracuse, NY, USA.
Upstate New York Poison Center, Department of Emergency Medicine, Upstate Medical University, 750 E. Adams St., Syracuse, NY, 13501, USA.
J Med Toxicol. 2017 Jun;13(2):153-157. doi: 10.1007/s13181-017-0598-4. Epub 2017 Jan 12.
The diagnosis of ethylene glycol intoxication can be challenging. Definitive testing for ethylene glycol is not readily available and clinical decisions are often based on clinical suspicion and the results of more readily available tests. One of these findings is hypocalcemia, presumable through complexation with the ethylene glycol metabolite oxalate.
We performed a retrospective review of all patients admitted to a tertiary care hospital between 2005 and 2013 with laboratory confirmed ethylene glycol intoxication. Serum calcium on presentation was compared to blood gas pH on presentation as well as presentation serum bicarbonate.
We did not find any relationship between calcium and serum pH either by linear regression or when dichotomized by pH ≥ or <7.3. We did observe an inverse relationship between serum calcium and bicarbonate.
Hypocalcemia is not commonly observed following ethylene glycol poisoning, even in acidotic patients.
乙二醇中毒的诊断可能具有挑战性。乙二醇的确诊检测不易获得，临床决策通常基于临床怀疑以及更容易获得的检测结果。其中一个发现是低钙血症，推测是由于与乙二醇代谢产物草酸盐络合所致。
我们对2005年至2013年间入住一家三级护理医院且实验室确诊为乙二醇中毒的所有患者进行了回顾性研究。将入院时的血清钙与入院时的血气pH值以及入院时的血清碳酸氢盐进行比较。
通过线性回归或按pH值≥或<7.3进行二分法分析时，我们均未发现钙与血清pH值之间存在任何关系。我们确实观察到血清钙与碳酸氢盐之间呈负相关。
即使在酸中毒患者中，乙二醇中毒后也不常出现低钙血症。
