Tufkova Stoilka G, Yankov Ivan V, Paskaleva Diana A
Second Department of Internal Diseases, Toxicology Section, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria
Department of Pediatrics and Genetic Diseases, St. George University Hospital, Plovdiv, Bulgaria
Folia Med (Plovdiv). 2017 Sep 1;59(3):303-309. doi: 10.1515/folmed-2017-0058.
There is no specific toxicological screening of clinical laboratory parameters in clinical toxicology when it comes to acute exogenous poisoning.
To determine routine clinical laboratory parameters and indicators for assessment of vital functions in patients with acute intoxications.
One hundred and fifty-three patients were included in the present study. They were hospitalized in the Department of Clinical Toxicology at St. George University Hospital, Plovdiv for cerebral toxicity inducing medication (n = 45), alcohol (n = 40), heroin abuse (n = 33). The controls were 35. The laboratory tests were conducted in compliance with the standards of the clinical laboratory. We used the following statistical analyses: analysis of variance (the ucriterion of normal distribution, the Student's t-test, dispersion analysis based on ANOVA) and non-parametric analysis.
Based on the routine hematological parameters with statistically significant changes in three groups of poisoning are: red blood cells, hematocrit, hemoglobin (except alcohol intoxication) and leukocytes. We found statistically significant changes in serum total protein, sodium and bilirubin. The highest statistical significance is the increased activity of AST and ALT.
We present a model for selection of clinical laboratory tests for severe acute poisoning with modern equipment under standardized conditions. The results of the study suggest that the clinical laboratory constellation we used can be used as a mandatory element in the diagnosis of moderate and severe intoxication with the mentioned toxic substances.
在急性外源性中毒的临床毒理学中，尚无针对临床实验室参数的特定毒理学筛查。
确定用于评估急性中毒患者重要功能的常规临床实验室参数和指标。
本研究纳入了153例患者。他们因脑毒性诱导药物（n = 45）、酒精（n = 40）、海洛因滥用（n = 33）而入住普罗夫迪夫圣乔治大学医院临床毒理学部。对照组为35例。实验室检测按照临床实验室标准进行。我们采用了以下统计分析方法：方差分析（正态分布的u检验、学生t检验、基于方差分析的离散分析）和非参数分析。
基于常规血液学参数，三组中毒中具有统计学显著变化的是：红细胞、血细胞比容、血红蛋白（酒精中毒除外）和白细胞。我们发现血清总蛋白、钠和胆红素存在统计学显著变化。统计学意义最高的是AST和ALT活性增加。
我们提出了一个在标准化条件下使用现代设备对严重急性中毒进行临床实验室检测选择的模型。研究结果表明，我们所使用的临床实验室指标组合可作为诊断上述有毒物质中度和重度中毒的必要要素。
