Department of Regulatory Relations on the Circulation of Pharmaceuticals and Medical Products, Sechenov First Moscow State Medical University, Moscow, Russian Federation.
Department of Chemistry, Sechenov First Moscow State Medical University, Moscow, Russian Federation.
J Environ Sci Health A Tox Hazard Subst Environ Eng. 2021;56(4):445-453. doi: 10.1080/10934529.2021.1885905. Epub 2021 Feb 11.
The aim of this paper is to study the clinical features of severe intoxications with thallium salts and developing effective care schemes for the application of potassium hexacyanoferrate (II) and deferasirox for correction of detected disorders. A total of 39 patients diagnosed with severe thallium salt poisoning were examined in two groups. Group I comprised 20 patients with severe thallium salt poisoning, who were prescribed with potassium-iron hexacyanoferrate in a dose of 250 mg/kg/day per os, intravenous potassium infusions, furosemide intravenously in amount of 40 mg three times per, and hemodialysis until the thallium level in the blood dropped below 10 mg/L, lactulose 30 mL two times per day per os. Group II consisted of 19 people with severe thallium salt poisoning, which in addition to the above treatment, received Deferasirox in a dosage of 500 mg two times per day per os. The clinical picture of severe poisoning with thallium salts is characterized by lesions of the gastrointestinal tract, nervous system (central and peripheral), alopecia, heart rhythm disorders, and myocardial ischemia zones. Extension of standard therapy with potassium-iron by adding hexacyanoferrate deferasirox showed better effect on thallium elimination rate and improved functional state of liver and kidneys in patients with severe thallium salt poisoning.
本文旨在研究铊盐重度中毒的临床特征,并制定有效的护理方案,应用六氰合铁(II)酸钾和地拉罗司纠正已发现的紊乱。共检查了两组 39 例重度铊盐中毒患者。第 I 组包括 20 例重度铊盐中毒患者,给予 250mg/kg/天的六氰合铁(II)酸钾口服、静脉补钾、呋塞米 40mg 静脉注射,每日 3 次,以及血液透析,直至血液中的铊水平降至 10mg/L 以下,口服乳果糖 30mL,每日 2 次。第 II 组包括 19 例重度铊盐中毒患者,除上述治疗外,还给予地拉罗司 500mg,每日口服 2 次。铊盐重度中毒的临床特征为胃肠道、神经系统(中枢和外周)、脱发、心律失常和心肌缺血区损伤。在标准的六氰合铁(II)钾治疗中加入地拉罗司可以提高铊的清除率,并改善重度铊盐中毒患者的肝肾功能状态。