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[对乙酰氨基酚实验室分析的改进与统一可实现更安全的中毒病例评估]

[Improved and harmonised laboratory analysis of paracetamol provides safer assessment of poisoning cases].

作者信息

Nordmark Grass Johanna, Elmgren Anders, Helander Anders

机构信息

Giftinformationscentralen - Stockholm, Sweden Giftinformationscentralen - Stockholm, Sweden.

Sahlgrenska Universitetssjukhuset - Klinisk kemi Göteborg, Sweden Sahlgrenska Universitetssjukhuset - Klinisk kemi Göteborg, Sweden.

出版信息

Lakartidningen. 2019 Jul 29;116:FPMA.

Abstract

Toxicological analysis is an important part of the acute treatment of various intoxications. Rapid laboratory responses are important for the patient to be assessed and treated correctly, and also to exclude poisoning and thus avoid unjustified and costly overtreatment. In Sweden, paracetamol (acetaminophen) is one of the most common pharmaceuticals in drug poisoning. Paracetamol overdose can cause severe liver damage unless treated early with the antidote acetylcysteine. A nation-wide initiative for improved laboratory measurement of paracetamol in plasma/serum samples has resulted in a marked reduction in the inter-laboratory coefficient of variation to generally below 10%. The introduction of a harmonized national reporting range for plasma/serum paracetamol covering at least 50-5 000 µmol/l was also recommended. This initiative will hopefully contribute to better healthcare from both a patient and health resource perspective in cases of paracetamol poisoning.

摘要

毒理学分析是各种中毒急性治疗的重要组成部分。快速的实验室反应对于正确评估和治疗患者非常重要,同时也有助于排除中毒情况,从而避免不合理且昂贵的过度治疗。在瑞典,对乙酰氨基酚(扑热息痛)是药物中毒中最常见的药物之一。除非早期使用解毒剂乙酰半胱氨酸进行治疗,对乙酰氨基酚过量可导致严重肝损伤。一项旨在改进血浆/血清样本中对乙酰氨基酚实验室测量的全国性倡议已使实验室间变异系数显著降低,总体降至10%以下。还建议引入统一的全国血浆/血清对乙酰氨基酚报告范围,涵盖至少50 - 5000 µmol/l。从患者和卫生资源角度来看,这项倡议有望在对乙酰氨基酚中毒病例中促进更好的医疗保健。

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