Stašinskis Roberts, Stašinska Katrīna, Mukāns Maksims, Graudiņš Andis, Liguts Viesturs, Lejnieks Aivars
Riga East University Hospital, Riga, Latvia.
Riga Stradins University, Riga, Latvia.
Proc (Bayl Univ Med Cent). 2022 Apr 27;35(4):460-465. doi: 10.1080/08998280.2022.2062550. eCollection 2022.
Ethylene glycol is a sweet-tasting toxic alcohol contained in a variety of chemical preparations. In patients poisoned with ethylene glycol, diagnosis is often based upon clinical suspicion and nonspecific tests. Hypocalcemia is often present due to calcium oxalate crystals formed by oxalic acid metabolite complexation. This retrospective study involved a review of clinical records of patients with a diagnosis of ethylene glycol poisoning. Results of blood gas samples, lactate, ionized calcium, and serum creatinine were documented and compared between various groups. The ionized calcium concentration was below the normal range in 59% of cases at the time of presentation and more commonly associated with a blood pH of <7.3 in 79% of cases. The number of patients with a low ionized calcium concentration increased over time. A low ionized calcium concentration was a common finding in cases of severe ethylene glycol poisoning and was more commonly associated with patients exhibiting metabolic acidosis or developing acute kidney injury or death. Ionized calcium concentration on presentation may be an additional marker in concert with blood pH that can be used in the risk assessment and stratification of severity and complications of ethylene glycol poisoning.
乙二醇是一种存在于多种化学制剂中的有甜味的有毒醇类。在乙二醇中毒的患者中，诊断通常基于临床怀疑和非特异性检查。由于草酸代谢产物络合形成草酸钙晶体，常出现低钙血症。这项回顾性研究涉及对诊断为乙二醇中毒患者的临床记录进行审查。记录并比较了不同组之间血气样本、乳酸、离子钙和血清肌酐的结果。就诊时59%的病例离子钙浓度低于正常范围，79%的病例更常与血pH值<7.3相关。离子钙浓度低的患者数量随时间增加。低离子钙浓度是严重乙二醇中毒病例中的常见发现，更常与表现为代谢性酸中毒、发生急性肾损伤或死亡的患者相关。就诊时的离子钙浓度可能是与血pH值协同的一个额外标志物，可用于乙二醇中毒严重程度和并发症的风险评估及分层。
