Ringler Sandra, Gmuer Roman, Faber Katrin, Bleisch Jörg, Müggler Simon Andreas
1 Klinik für Innere Medizin, Spital Zollikerberg.
2 Tox Info Suisse, Assoziiertes Institut der Universität Zürich.
Praxis (Bern 1994). 2018;107(20):1097-1106. doi: 10.1024/1661-8157/a003071.
Ethylene Glycol Intoxication Abstract. Ethylene glycol is a sweet-tasting alcohol used in common antifreeze and other industrial solutions. Without appropriate therapy, intoxication with ethylene glycol can result in severe metabolic acidosis, acute renal failure, and in death. After gastrointestinal resorption, hepatic metabolism starts with oxidation by alcohol dehydrogenase and results in severe anion gap metabolic acidosis. Other metabolic products are calcium oxalate crystals, which can deposit in several tissues like the kidneys and lead to acute tubular necrosis with reversible renal failure. The crucial therapeutic step is rapid inhibition of alcohol dehydrogenase with fomepizole or ethanol to avoid the formation of toxic metabolites. Additionally, haemodialysis is the most effective way to eliminate ethylene glycol as well as its toxic metabolites. If therapy is initiated rapidly, prognosis is favorable.
乙二醇中毒摘要。乙二醇是一种用于常见防冻液和其他工业溶液的甜味醇类。若不进行适当治疗,乙二醇中毒可导致严重代谢性酸中毒、急性肾衰竭甚至死亡。经胃肠道吸收后,肝脏代谢首先通过乙醇脱氢酶进行氧化,从而导致严重的阴离子间隙代谢性酸中毒。其他代谢产物是草酸钙晶体,可沉积于肾脏等多个组织,导致急性肾小管坏死及可逆性肾衰竭。关键的治疗步骤是用甲吡唑或乙醇迅速抑制乙醇脱氢酶,以避免形成有毒代谢产物。此外,血液透析是清除乙二醇及其有毒代谢产物的最有效方法。如果迅速开始治疗,预后良好。