Chan T Y, Critchley J A, Chan A Y
Department of Clinical Pharmacology, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories.
Vet Hum Toxicol. 1995 Apr;37(2):154-6.
The reported incidence of renal failure in unselected patients with paracetamol poisoning is about 1-2%. Since the introduction of antidotal therapy for paracetamol poisoning in 1973, renal failure is now mainly seen in those admitted too late for effective therapy and is usually associated with liver damage. To determine the incidence of renal failure in Chinese patients with paracetamol poisoning, a retrospective survey was conducted of 224 patients admitted to the Prince of Wales Hospital, Hong Kong, with paracetamol poisoning from January 1988 to January 1994. Of the 28 patients at risk (plasma paracetamol concentrations above the recommended treatment line), 13 developed liver damage which was severe in 5. One patient with severe liver damage developed a transient increase in plasma creatinine concentration from 90 to 116 umol/L. All 28 patients completely recovered. Renal failure was uncommon in Chinese subjects (0.4%), and this was probably related to a lower incidence of liver damage which may be due to less chronic alcoholism as well as ethnic differences in paracetamol metabolism resulting in an inherent reduced susceptibility to its liver and renal toxicity.
在未经过挑选的对乙酰氨基酚中毒患者中，据报道肾衰竭的发生率约为1%-2%。自1973年引入对乙酰氨基酚中毒的解毒治疗以来，肾衰竭现在主要见于那些因就医过晚而无法接受有效治疗的患者，并且通常与肝损伤相关。为了确定中国对乙酰氨基酚中毒患者中肾衰竭的发生率，对1988年1月至1994年1月期间香港威尔士亲王医院收治的224例对乙酰氨基酚中毒患者进行了一项回顾性调查。在28例有风险的患者（血浆对乙酰氨基酚浓度高于推荐治疗线）中，13例出现肝损伤，其中5例为严重肝损伤。1例严重肝损伤患者的血浆肌酐浓度从90 μmol/L短暂升高至116 μmol/L。所有28例患者均完全康复。肾衰竭在中国患者中并不常见（0.4%），这可能与肝损伤发生率较低有关，肝损伤发生率较低可能是由于慢性酒精中毒较少以及对乙酰氨基酚代谢的种族差异导致对其肝毒性和肾毒性的固有易感性降低。
