Mohammed Sarah S, Zaaqoq Ayman, Talaat Shimaa, Abdelkader Salma I
Forensic Medicine and Clinical Toxicology Department, Faculty of Medicine, Ain Shams University, Abbassia, Cairo 1181, Egypt.
Biochemistry Department, Poison Control Center, Ain Shams University, Abbassia Cairo 1181, Egypt.
Toxicol Res (Camb). 2025 Jan 8;14(1):tfae234. doi: 10.1093/toxres/tfae234. eCollection 2025 Jan.
The incidence of acute organophosphate (OP) poisoning has steadily increased in developing countries. Many studies showed that oxidative stress could have a significant role in its mechanism. The current study aimed to evaluate the role of N acetylcysteine (NAC) as an antioxidant in acute OP poisoned. A randomized, controlled, parallel-group trial was conducted in the period from the beginning of January 2022 to the end of June 2022. The study included 56 acute OP poisoned patients admitted to the intensive care unit (ICU) at the Poison Control Center of Ain Shams University Hospitals within 6 h after the exposure. The patients were randomly allocated in two equal groups; group (A): received the standard treatment plus NAC in a total dose of 300 mg/kg administered intravenously (IV) while group (B) received the standard treatment. Then both groups were compared as regards clinical parameters, laboratory investigations, ECG, and outcomes. Baseline parameters were comparable between the groups. However, NAC treatment significantly elevated concentrations of both serum catalase and glutathione peroxidase levels at 24 h, it did not significantly affect the total dose of atropine required, duration of atropine and oximes treatment or need for mechanical ventilation, and length of hospital stay. Mortality was lower in the NAC group (2 out of 28) than the standard treatment-only group (5 out of 28) but the difference was not statistically significant. This trial found that NAC improved antioxidant enzyme levels including serum CAT and GPX but did not affect clinically relevant outcomes.
在发展中国家，急性有机磷（OP）中毒的发生率一直在稳步上升。许多研究表明，氧化应激在其发病机制中可能起重要作用。本研究旨在评估N-乙酰半胱氨酸（NAC）作为抗氧化剂在急性OP中毒中的作用。在2022年1月初至2022年6月底期间进行了一项随机、对照、平行组试验。该研究纳入了56例急性OP中毒患者，这些患者在接触后6小时内被送往艾因夏姆斯大学医院中毒控制中心的重症监护病房（ICU）。患者被随机分为两组，每组人数相等；A组：接受标准治疗加NAC，总剂量为300mg/kg，静脉注射（IV），而B组接受标准治疗。然后比较两组的临床参数、实验室检查、心电图和结局。两组的基线参数具有可比性。然而，NAC治疗在24小时时显著提高了血清过氧化氢酶和谷胱甘肽过氧化物酶的浓度，但对所需阿托品的总剂量、阿托品和肟类药物的治疗持续时间或机械通气需求以及住院时间没有显著影响。NAC组的死亡率（28例中有2例）低于仅接受标准治疗的组（28例中有5例），但差异无统计学意义。该试验发现，NAC提高了抗氧化酶水平，包括血清CAT和GPX，但不影响临床相关结局。
