Ambre J, Alexander M
JAMA. 1977 Aug 8;238(6):500-1. doi: 10.1001/jama.238.6.500.
With increasing frequency, the physician is confronted with the problem of determining the risk of liver toxicity in a person who may have ingested an overdose of acetaminophen. To be effective, antidotal therapy must be given early after acetaminophen ingestion when the patient, despite the toxic injury occurring in his liver, may appear quite well. We have reviewed the cases of the first five persons who came to our institution with a history of having ingested a large overdose of acetaminophen. In each case plasma or serum acetaminophen levels were low and substantial liver injury did not occur. Measurement of acetaminophen levels, indicating the amount of drug absorbed, were a more reliable index of the risk of toxic liver injury and the need for antidotal therapy than the estimate of the dose ingested.
越来越频繁地，医生面临着确定可能过量服用对乙酰氨基酚的人发生肝毒性风险的问题。为了有效，解毒治疗疗法疗法必须在摄入对乙酰氨基酚后尽早给予，此时患者尽管肝脏发生了毒性损伤，但可能看起来相当健康。我们回顾了前五名因过量服用对乙酰氨基酚前来我院就诊的患者的病例。在每个病例中，血浆或血清对乙酰氨基酚水平都很低，且未发生严重肝损伤。与摄入剂量的估计相比，对乙酰氨基酚水平的测量（表明吸收的药物量）是肝毒性损伤风险和解毒治疗必要性的更可靠指标。
