在医院急诊部门中，苯丙胺和甲基苯丙胺中毒的临床特征和实验室确认的作用。

Amphetamine and methamphetamine poisonings attended in hospital emergency departments: clinical features and the usefulness of laboratory confirmation.

机构信息

Servicio de Psiquiatría, Hospital Universitari Son Espases, Palma de Mallorca, España.

Servicio de Análisis Clínicos, Hospital Universitari Son Llàtzer, Palma de Mallorca, España. Instituto de Investigación Sanitaria de las Islas Baleares (IdISBa), Palma de Mallorca, España.

出版信息

Emergencias. 2020 Feb;32(1):26-32.

PMID:31909909

Abstract

OBJECTIVES

To determine whether clinical and toxicologic findings differed between cases of amphetamine (AMP) and methamphetamine (mAMP) poisoning attended in 2 Balearic Island hospital emergency departments.

MATERIAL AND METHODS

Retrospective observational study of AMP and mAMP cases with laboratory confirmation between 2013 and 2018. We compared clinical and toxicologic variables as well as clinical management between groups.

RESULTS

A total of 120 cases were found: 86 (71.7%) with AMP poisoning and 34 (28.3%) with mAMP poisoning. 2) Drug poisoning was confirmed by gas chromatography associated with mass spectrometry (GC-MS) in 787 urine samples found to be positive during screening. One hundred fifty-four (19.6%) were confirmed by GC-MS. Thirtyfour of them did not meet the inclusion criteria. 3) Significant differences between AMP and mAMP cases were found for age (32.3 vs 28.4 y, respectively); sex (72.1% vs 94.1% men); and Spanish nationality (64.0% vs 29.4%). Reasons for admission and clinical features also differed: the reasons were aberrant behavior (15.1% in the AMP group vs 0% in the mAMP group) and palpitations (1.2% vs 20.6%); agitation was observed in 27.9% and 8.8%, respectively. Clinical management was similar in the 2 groups. Multiple drug poisoning was detected in 76.6% patients and was more common in patients in the AMP group (82.6% vs 61.8%). The additional drugs in these cases were mainly cocaine (63.0%), cannabis (48.9%), 3,4-methylenedioxy-N-methamphetamine (MDMA) (38.0%), and alcohol (35.9%). Cannabis was detected in a significantly higher proportion in the AMP group (45.3%) than in the mAMP group (17.6%). False positives were found in 78.7% of the samples. The culprit drug was most often MDMA (71.2%).

CONCLUSION

AMP poisonings were associated with age over 30 years, Spanish nationality, aberrant behavior, agitation, multiple drug findings, and the use of cannabis. Poisonings caused by mAMP abuse were associated with age under 30 years, non-Spanish nationality, palpitations, and single-drug use.

摘要

目的

确定在 2 个巴利阿里群岛医院急诊部门就诊的安非他命（AMP）和甲基苯丙胺（mAMP）中毒病例的临床和毒理学表现是否存在差异。

材料和方法

这是一项对 2013 年至 2018 年期间经实验室确认为 AMP 和 mAMP 中毒的病例进行的回顾性观察性研究。我们比较了两组之间的临床和毒理学变量以及临床管理。

结果

1）共发现 120 例：86 例（71.7%）为 AMP 中毒，34 例（28.3%）为 mAMP 中毒。2）787 份筛查阳性的尿液样本通过气相色谱-质谱联用仪（GC-MS）证实了药物中毒，154 份（19.6%）经 GC-MS 证实。其中 34 份不符合纳入标准。3）AMP 和 mAMP 病例之间存在显著差异，包括年龄（分别为 32.3 和 28.4 岁）、性别（分别为 72.1%和 94.1%的男性）和西班牙国籍（分别为 64.0%和 29.4%）。入院原因和临床特征也不同：AMP 组的原因是异常行为（15.1%），而 mAMP 组无此原因；AMP 组的心悸（1.2%），而 mAMP 组的心悸（20.6%）；激动分别见于 27.9%和 8.8%的病例。两组的临床管理相似。76.6%的患者存在多种药物中毒，AMP 组更为常见（82.6% vs 61.8%）。这些病例中主要发现的其他药物是可卡因（63.0%）、大麻（48.9%）、3,4-亚甲二氧基-N-甲基苯丙胺（MDMA）（38.0%）和酒精（35.9%）。AMP 组中检测到大麻的比例明显高于 mAMP 组（45.3% vs 17.6%）。78.7%的样本出现假阳性。罪魁祸首药物多为 MDMA（71.2%）。