Tsatsakis A M, Perakis K, Koumantakis E
Laboratory of Toxicology, School of Medicine, University of Crete, Voutes, Greece.
Vet Hum Toxicol. 1996 Apr;38(2):113-7.
Ten cases of acute paraquat poisonings with lethal (n = 5) and non-lethal (n = 5) outcomes are presented. Paraquat plasma and urine levels of the patients on admission (from 2 to 41 h after ingestion) at the peripheral hospitals varied from 0.4 to 6.0 and 0.5 to 12.8 micrograms/ml, respectively. Besides standard supportive treatment, hemoperfusion/hemodialysis and/or plasmapheresis were performed for therapy, which in 1 case lasted for 28 d. The pharmacokinetic data from patient paraquat elimination confirmed considerable paraquat rebound from tissues to blood circulation and marked the need for continued therapy even with undetectable paraquat plasma levels. Postmortem analysis showed that while paraquat was mainly distributed in kidney (807 micrograms/g), lung (479 micrograms/g) and liver (206 micrograms/g), amounts were also detected in thyroid (64 micrograms/g), testis (21 micrograms/g), vitreous humor (45 micrograms/ml) and cerebrospinal fluid (7.4 micrograms/ml). Paraquat crossed the placenta and concentrated there to higher levels than in the mother's blood. The fetus seemed to tolerate the mother's paraquat intoxication while dependent on placental circulation.
本文报告了10例急性百草枯中毒病例，其中5例死亡，5例存活。在外围医院，患者入院时（摄入后2至41小时）的百草枯血浆和尿液水平分别为0.4至6.0微克/毫升和0.5至12.8微克/毫升。除了标准的支持治疗外，还进行了血液灌流/血液透析和/或血浆置换治疗，其中1例持续了28天。患者百草枯消除的药代动力学数据证实，百草枯从组织大量反弹至血液循环，这表明即使血浆中百草枯水平检测不到，仍需持续治疗。尸检分析表明，百草枯主要分布在肾脏（807微克/克）、肺（479微克/克）和肝脏（206微克/克），在甲状腺（64微克/克）、睾丸（21微克/克）、玻璃体液（45微克/毫升）和脑脊液（7.4微克/毫升）中也检测到了一定量。百草枯可穿过胎盘并在胎盘中浓缩至高于母体血液中的水平。胎儿在依赖胎盘循环时似乎能够耐受母体的百草枯中毒。
