Am Fam Physician. 1993 Jan;47(1):163-71.
Methanol is used in a variety of commercial and consumer products. Increased use of methanol as a motor fuel may lead to higher ambient air levels and a greater potential for ingestion from siphoning accidents. Methanol toxicity initially is not characterized by severe toxic manifestations. Pathophysiologically, methanol toxicity represents a classic example of "lethal synthesis," in which toxic metabolites can cause fatality after a characteristic latent period. Methanol is well absorbed following inhalation, ingestion or cutaneous exposure. It is oxidized in the liver to formaldehyde, then to formic acid, which contributes to the profound metabolic acidosis occurring in acute methanol poisoning. The metabolic products of methanol can produce a syndrome of delayed-onset acidosis, obtundation, visual disturbance and death. Intravenous sodium bicarbonate therapy should be considered if the patient's blood pH is below 7.2. Symptoms and history determine whether intravenous ethanol therapy and hemodialysis should be instituted.
甲醇被用于各种商业和消费产品中。甲醇作为发动机燃料使用的增加可能导致环境空气中甲醇含量升高，并且因虹吸事故而摄入甲醇的可能性更大。甲醇中毒最初并无严重中毒表现。从病理生理学角度来看，甲醇中毒是“致死性合成”的典型例子，即有毒代谢产物在一段特征性潜伏期后可导致死亡。甲醇经吸入、摄入或皮肤接触后均可被很好地吸收。它在肝脏中被氧化为甲醛，然后再氧化为甲酸，这会导致急性甲醇中毒时出现严重的代谢性酸中毒。甲醇的代谢产物可引发迟发性酸中毒、意识障碍、视觉障碍和死亡综合征。如果患者血液pH值低于7.2，应考虑静脉注射碳酸氢钠治疗。症状和病史决定是否应进行静脉注射乙醇治疗和血液透析。
