Denison H, Kaczynski J, Wallerstedt S
Dept. of Medicine, Ostra Hospital, Gothenburg, Sweden.
Scand J Gastroenterol. 1987 Aug;22(6):701-4. doi: 10.3109/00365528709011146.
The clinical pattern of paracetamol-induced acute liver damage was studied with regard to whether the intoxication was acute or due to continuous use. This condition was found to be caused almost as often by accidental chronic medication as by acute intoxication, with annual incidences per 100,000 of 0.8 and 1.2 cases, respectively. The liver damage found in 18% of the cases of acute intoxication was generally mild, probably due to an early antidote treatment. In contrast, in the chronic intoxicated cases the liver damage was more pronounced and often accompanied by a severe renal dysfunction. Since all these patients were alcohol abusers, and the reported paracetamol intake was not remarkably high, it seems reasonable to recommend that paracetamol should be prescribed with great caution to alcoholics, and absolutely not for continuous use.
对乙酰氨基酚所致急性肝损伤的临床模式,针对中毒是急性的还是因持续用药所致进行了研究。发现这种情况几乎同样常见于意外慢性用药和急性中毒,每10万人的年发病率分别为0.8例和1.2例。在18%的急性中毒病例中发现的肝损伤通常较轻,可能是由于早期进行了解毒治疗。相比之下,在慢性中毒病例中,肝损伤更为明显,且常伴有严重的肾功能障碍。由于所有这些患者均为酗酒者,且报告的对乙酰氨基酚摄入量并非显著偏高,因此建议对酗酒者开具对乙酰氨基酚时应极为谨慎,绝对不应连续使用,这似乎是合理的。