Sabeel A I, Kurkus J, Lindholm T
Department of Nephrology, University Hospital, Lund, Sweden.
Scand J Urol Nephrol. 1995 Jun;29(2):125-9. doi: 10.3109/00365599509180551.
During a period of 10 years 18 men were treated for severe ethylene glycol (EG) intoxication. All patients received supportive measures and ethanol infusion. Hemodialysis (HD) was applied in 11 patients (Group I) whereas 7 patients, who exhibited more advanced toxicity symptoms, received peritoneal dialysis (PD) simultaneously with HD (Group II). Patients in Group II showed more advanced acidosis on admission than in Group I (Base excess -27.1 mmol/l versus -16.8 mmol/l, p < 0.0075). The results of treatment in these two groups of patients were compared. All patients in Group I survived and one patient in Group II died. The patients in Group II were discharged with higher serum creatinine and follow up time to improve renal function was longer than in Group I (252 versus 149 mumol/l, p < 0.015 and 23 versus 7.9 weeks, p < 0.05 respectively). No correlations were found between serum EG and grade of acidosis on admission or serum EG and subsequent increase of serum creatinine but acidosis on admission was highly correlated to the rise of serum creatinine after the 72 hours of observation time (p < 0.0001). It is concluded, that combined HD and PD treatment was beneficial in the presented patients as it corrected acidosis earlier and could eliminate EG and its toxic metabolites faster, improving prognosis.
在10年期间，18名男性因严重乙二醇（EG）中毒接受治疗。所有患者均接受了支持性措施和乙醇输注。11名患者（第一组）接受了血液透析（HD），而7名出现更严重毒性症状的患者在接受HD的同时还接受了腹膜透析（PD）（第二组）。第二组患者入院时的酸中毒程度比第一组更严重（碱剩余-27.1 mmol/L对-16.8 mmol/L，p<0.0075）。比较了这两组患者的治疗结果。第一组所有患者均存活，第二组有1名患者死亡。第二组患者出院时血清肌酐水平更高，肾功能恢复正常所需的随访时间比第一组长（分别为252对149 μmol/L，p<0.015；23对7.9周，p<0.05）。入院时血清EG水平与酸中毒程度之间以及血清EG水平与随后血清肌酐升高之间均未发现相关性，但入院时的酸中毒与观察72小时后血清肌酐升高高度相关（p<0.0001）。得出的结论是，HD和PD联合治疗对这些患者有益，因为它能更早地纠正酸中毒，更快地清除EG及其有毒代谢产物，从而改善预后。
