Nolla-Salas J, Nogué Xarau S, Marruecos Sant L, Palomar Martínez M, Martínez Pérez J
Servicio de Medicina Intensiva, Hospital del Mar.
Med Clin (Barc). 1995 Feb 4;104(4):121-5.
The present study reviews acute intoxication by methanol and ethylenglycol analyzing its form of presentation, treatment applied and prognosis.
A retrospective study performed in 5 hospitals from the Barcelona area (Spain) from January 1984 to December 1993 is reported.
Eighteen patients, 16 intoxicated by methanol and 2 by ethylenglycol were reviewed. The blood levels of methanol on admission ranged from 350 to 4,600 mg/l (mean = 1,649 +/- 1,220 mg/l). The clinical course was initially characterized by alteration of the level of consciousness (in 61% the index of Glasgow of coma was < or = 7) and development of metabolic acidosis (pH < or = 6.80 in 44% of cases). Eighty-seven percent of patients intoxicated by methanol had visual disorders. Treatment consisted in the administration of ethanol, bicarbonate and extrarenal exchange. Mortality was 44%, being greater among patients with the lowest initial pH (p = 0.0001) and with the lowest concentration of bicarbonates (p < 0.03). The patients with lower pH (r2 = 0.65, p < 0.002) and with a lower value of blood bicarbonate (r2 = 0.87; p < 0.0001) on admission were significantly more severe. Sequelae are present in 55% of the survivors.
Intoxication by methanol and ethylenglycol cause severe metabolic acidosis, with high anion and osmolar gaps which may rapidly lead to death or to sequelae in survivors if diagnosis is delayed and specific treatment is not initiated early.
本研究回顾甲醇和乙二醇急性中毒情况，分析其临床表现形式、所采用的治疗方法及预后。
报告了一项于1984年1月至1993年12月在西班牙巴塞罗那地区5家医院开展的回顾性研究。
共回顾了18例患者，其中16例为甲醇中毒，2例为乙二醇中毒。入院时甲醇血浓度范围为350至4600毫克/升（平均 = 1649 ± 1220毫克/升）。临床过程最初的特征为意识水平改变（61%的患者格拉斯哥昏迷指数≤7）及代谢性酸中毒的发生（44%的病例pH≤6.80）。87%的甲醇中毒患者有视觉障碍。治疗包括给予乙醇、碳酸氢盐及肾外血液滤过。死亡率为44%，初始pH最低的患者死亡率更高（p = 0.0001），碳酸氢盐浓度最低的患者死亡率也更高（p < 0.03）。入院时pH较低（r2 = 0.65，p < 0.002）及血碳酸氢盐值较低（r2 = 0.87；p < 0.0001）的患者病情明显更严重。55%的幸存者有后遗症。
甲醇和乙二醇中毒会导致严重的代谢性酸中毒，伴有高阴离子间隙和高渗透压间隙，如果诊断延迟且未尽早开始特异性治疗，可能会迅速导致死亡或使幸存者出现后遗症。
