Frelon J H, Merigot P, Garnier R, Bismuth C, Efthymiou M L
Toxicol Eur Res. 1983 Jul;5(4):163-9.
Twenty years after the publication of the first cases, the intoxication with the herbicide Paraquat still has a low prognosis because of no efficient treatment. But many studies have allowed the definition of prognostic factors. Nearly, BISMUTH and als(2) demonstrated that the following criteria are significant: the oral route, the gastric lesions, the organic renal failure, the plasma-Paraquat concentration. Through a series of cases collected in 1981 at the Poison Control Center of Paris, the following prognostic factors have been studied: route of administration, sex of patient, circumstances of the poisoning, ingested volume, concentration of the solution, existence of an emetic in the commercial solution, gastric content, lesions of the upper digestive tract (mouth, oesophagus, stomach), renal impairment, hepatic failure, blood gasometry, lung function tests, plasma and urine paraquat concentrations. Forty-one cases were collected during this period, with thirty-four concerning acute Paraquat poisonings in humans. We studied twenty-seven of them caused by acute oral poisoning, with accidental circumstances in nine cases (two died) and intentional circumstances in eighteen cases (all died) (other cases concerned two ocular projections, four inhalations and one skin projection). The interest of this new investigation is the particularity of our series. Because of our recruitment (larger geographic distribution of patients, larger diversity of circumstances, of routes of administration, of ingested quantities, of treatments...). This series of cases is quite different from others previously published. This study confirms the validity of prognostic factors defined by BISMUTH and als(2). The factors, which look significant, strictly depend on the ingested quantity.(ABSTRACT TRUNCATED AT 250 WORDS)
在首例病例发表二十年后,由于缺乏有效的治疗方法,百草枯除草剂中毒的预后仍然很差。但许多研究已经明确了预后因素。几乎,比铋等人(2)证明以下标准具有重要意义:口服途径、胃部病变、器质性肾衰竭、血浆百草枯浓度。通过1981年在巴黎中毒控制中心收集的一系列病例,对以下预后因素进行了研究:给药途径、患者性别、中毒情况、摄入量、溶液浓度、商业溶液中是否存在催吐剂、胃内容物、上消化道(口腔、食道、胃)病变、肾功能损害、肝功能衰竭、血气分析、肺功能测试、血浆和尿液百草枯浓度。在此期间共收集了41例病例,其中34例为人类急性百草枯中毒。我们研究了其中27例由急性口服中毒引起的病例,9例为意外情况(2例死亡),18例为故意情况(全部死亡)(其他病例包括2例眼部喷洒、4例吸入和1例皮肤喷洒)。这项新研究的意义在于我们系列病例的特殊性。由于我们的招募方式(患者的地理分布更广、情况、给药途径、摄入量、治疗方法等更多样化)。这个病例系列与之前发表的其他系列有很大不同。本研究证实了比铋等人(2)定义的预后因素的有效性。这些看似重要的因素,严格取决于摄入量。(摘要截断于250字)