Beckett G J, Chapman B J, Dyson E H, Hayes J D
Gut. 1985 Jan;26(1):26-31. doi: 10.1136/gut.26.1.26.
Plasma glutathione S-transferase (GST) measurements have been used to study early changes in hepatocellular integrity after paracetamol overdose and treatment with N-acetylcysteine (NAC). Patients admitted within seven hours and successfully treated had raised or equivocal GST on admission and each showed a transient peak in GST approximately 12 hours after the overdose. Similar, though smaller changes in GST, were seen in untreated patients whose paracetamol level fell below the treatment line. The plasma GST concentrations in successfully treated patients were small compared with values found in patients who subsequently developed severe liver damage. The changes in GST concentration observed in patients who developed severe liver damage indicated that distinct early and late phases of paracetamol-induced hepatotoxicity occurred. Although the mechanism by which paracetamol exerts its early toxic effect is unclear, our data suggest that prompt treatment with NAC can successfully prevent both clinical and subclinical hepatotoxicity in this early period.
血浆谷胱甘肽S-转移酶（GST）检测已被用于研究对乙酰氨基酚过量服用及用N-乙酰半胱氨酸（NAC）治疗后肝细胞完整性的早期变化。在7小时内入院并成功接受治疗的患者入院时GST升高或不明确，且每位患者在过量服用后约12小时GST均出现短暂峰值。对乙酰氨基酚水平降至治疗线以下的未治疗患者也观察到了类似但较小的GST变化。与随后发生严重肝损伤的患者相比，成功治疗患者的血浆GST浓度较低。发生严重肝损伤患者中观察到的GST浓度变化表明，对乙酰氨基酚诱导的肝毒性存在明显的早期和晚期阶段。尽管对乙酰氨基酚发挥其早期毒性作用的机制尚不清楚，但我们的数据表明，在此早期阶段迅速用NAC治疗可成功预防临床和亚临床肝毒性。
