Palatnick W, Tenenbein M
Department of Emergency Medicine, University of Manitoba, Winnipeg, Canada.
Am J Emerg Med. 1996 Sep;14(5):454-5. doi: 10.1016/S0735-6757(96)90149-7.
To determine whether leukocytosis, hyperglycemia, vomiting, and opacities in abdominal radiographs are indicators of a serum iron concentration of > 300 micrograms/dL in adult iron overdose patients, a retrospective medical record review was undertaken at a university medical center of all patients older than 12 years of age for whom clinical data were collected before deferoxamine therapy and within 6 hours of iron ingestion. Forty-three patients met the inclusion criteria; 37 were female. The mean and range serum iron concentrations were 382 micrograms/dL and 58 to 710 micrograms/dL, with 34 patients having values of > 300 micrograms/dL. There were no statistically significant relationships between iron concentration of > 300 microgram/dL and leukocytosis, hyperglycemia, vomiting, and opacities in abdominal radiographs (P > .05). Sensitivities, specificities, and positive and negative predictive values indicate poor performance of these parameters as clinical predictors of serum iron concentration of > 300 micrograms/dL. Leukocytosis, hyperglycemia, vomiting, or the presence of opacities in abdominal X-rays are not indicators of a serum iron concentration of > 300 micrograms/dL in adults. These parameters should not be used to assess the severity of iron overdose or to guide its management.
为了确定白细胞增多、高血糖、呕吐以及腹部X光片上的不透明影是否为成年铁过量患者血清铁浓度>300微克/分升的指标，在一所大学医学中心对所有12岁以上且在去铁胺治疗前及铁摄入后6小时内收集了临床数据的患者进行了回顾性病历审查。43名患者符合纳入标准；37名是女性。血清铁浓度的平均值和范围分别为382微克/分升和58至710微克/分升，34名患者的值>300微克/分升。血清铁浓度>300微克/分升与白细胞增多、高血糖、呕吐以及腹部X光片上的不透明影之间无统计学显著关系（P>.05）。敏感度、特异度以及阳性和阴性预测值表明这些参数作为血清铁浓度>300微克/分升的临床预测指标表现不佳。白细胞增多、高血糖、呕吐或腹部X光片上存在不透明影并非成年患者血清铁浓度>300微克/分升的指标。这些参数不应被用于评估铁过量的严重程度或指导其治疗。
