Smith J M, Roberts W O, Hall S M, White T A, Gilbertson A A
Br Med J. 1978 Feb 11;1(6109):331-3. doi: 10.1136/bmj.1.6109.331.
Forty patients who had taken overdoses of paracetamol were treated with mercaptamine. Twenty-three patients given mercaptamine within 10 hours of poisoning had normal liver function tests at follow-up, and one could not be traced. In 16 patients mecraptamine was begun more than 10 hours after ingestion of paracetamol ("late" mercaptamine). Eight of these patients developed severe liver damage, which in six was moderate or severe before mercaptamine administration. Acute renal failure occurred in two patients; in one other renal function was temporarily severely impaired. At follow-up two patients were not available, and one admitted moribund had died soon after admission. The remaining 13 all had normal liver function tests. It is concluded that late mercaptamine is not dangerous and may prevent further liver damage.
40名过量服用扑热息痛的患者接受了巯基乙胺治疗。23名在中毒后10小时内接受巯基乙胺治疗的患者在随访时肝功能测试正常,1名患者无法追踪到。16名患者在摄入扑热息痛10小时后开始使用巯基乙胺(“延迟”使用巯基乙胺)。其中8名患者出现了严重肝损伤,6名患者在使用巯基乙胺前肝损伤就已为中度或重度。2名患者发生了急性肾衰竭;另有1名患者肾功能暂时严重受损。随访时2名患者无法联系到,1名入院时已奄奄一息的患者入院后不久死亡。其余13名患者肝功能测试均正常。结论是延迟使用巯基乙胺并无危险,且可能防止进一步的肝损伤。