Lu Xiaoxia, Liu Yanqing, Wang Chunyan, Dong Jianguang, Bai Lili, Zhang Chengcheng, Zhang Renzheng, Sun Chengwen, Qiu Zewu
Poisoning Treatment Department, Department of Hematology, Fifth Medical Center of Chinese PLA General Hospital, No. 8 Dong da Street, Fengtai District, Beijing 100071, China.
Toxicol Res (Camb). 2021 Jul 29;10(4):885-892. doi: 10.1093/toxres/tfab074. eCollection 2021 Aug.
Colchicine poisoning is complicated and has a high mortality rate. The aim of this study was to identify the pathogenic characteristics of colchicine poisoning cases and to propose a comprehensive treatment procedure. A total of 43 patients were divided into survival ( = 32) and death groups ( = 11) according to prognosis. The clinical data (basic information, clinical manifestations, laboratory tests, examination results, therapeutic schedule, response evaluation, and prognosis) were analyzed, and the comprehensive treatment was proposed. The ingestion doses were ≤0.5, 0.5-0.8, and ≥0.8 mg/kg, and the survival rates were 100, 83.33, and 28.60%. The causes of death were cardiovascular and bone marrow hematopoietic failures. We found that the order of organ damage was digestive tract, coagulation, muscle, heart, hematopoietic, lung, liver, and kidney, while the recovery order was digestive tract, coagulation, heart, hematopoietic, lung, muscle, kidney, and liver. Different doses of recombinant human granulocyte colony-stimulating factor and recombinant human thrombopoietin can shorten the severity and duration of neutropenia and thrombocytopenia. Plasma exchange combined with continuous veno-venous hemodialysis filtration treatment can increase survival time. The prognosis is positively correlated with the dose. Early removal of toxicants from the digestive tract and blood is essential. It is vital to give comprehensive treatment of multiple organ injuries， include the use of recombinant human granulocyte colony-stimulating factor, recombinant human thrombopoietin, plasma exchange, and continuous veno-venous hemodialysis filtration.
秋水仙碱中毒病情复杂，死亡率高。本研究旨在明确秋水仙碱中毒病例的致病特征，并提出综合治疗方案。根据预后情况，将43例患者分为存活组（n = 32）和死亡组（n = 11）。分析临床资料（基本信息、临床表现、实验室检查、检查结果、治疗方案、疗效评估及预后），并提出综合治疗方案。摄入剂量分别为≤0.5、0.5 - 0.8和≥0.8mg/kg，存活率分别为100%、83.33%和28.60%。死亡原因是心血管和骨髓造血功能衰竭。我们发现器官损伤顺序为消化道、凝血、肌肉、心脏、造血、肺、肝、肾，而恢复顺序为消化道、凝血、心脏、造血、肺、肌肉、肾、肝。不同剂量的重组人粒细胞集落刺激因子和重组人血小板生成素可缩短中性粒细胞减少和血小板减少的严重程度及持续时间。血浆置换联合持续静脉 - 静脉血液透析滤过治疗可延长生存时间。预后与剂量呈正相关。尽早从消化道和血液中清除毒物至关重要。对多器官损伤进行综合治疗至关重要，包括使用重组人粒细胞集落刺激因子、重组人血小板生成素、血浆置换和持续静脉 - 静脉血液透析滤过。
