Signs S A, Dickey-White H I, Vanek V W, Perch S, Schechter M D, Kulics A T
Department of Pharmacology, Northeastern Ohio Universities College of Medicine, Rootstown, USA.
Am J Emerg Med. 1996 Nov;14(7):665-70. doi: 10.1016/S0735-6757(96)90085-6.
The purpose of this investigation was to document the clinical presentation of emergency department (ED) patients who tested positive for concurrent cocaine (COC) and ethanol (EtOH) use and the incidence of cocaethylene (CE) formation in this study population. Four study groups were evaluated: (1) drug-free, (2) EtOH-only, (3) COC-only, and (4) COC plus EtOH. CE was detected in plasma or urine specimens in 88% of the COC/EtOH-positive patients, and correlated directly with plasma COC and its metabolite benzoylecognine. Blood pressure and body temperature did not vary across study groups. COC/EtOH-positive patients displayed a significantly higher mean respiratory rate while the EtOH-only study group had an elevated mean heart rate. No significant differences were detected with respect to cardiac and neurological complaints between study groups. Trauma complaints in the drug-positive groups were more frequent than the incidence reported in the drug-free population. COC/EtOH-positive patients had the greatest percentage of trauma complaints (34.6%). Nearly half of the patients who tested positive for CE cited trauma as the primary reason for reporting to the ED. We conclude that ED patients who have concurrently used COC and EtOH are more closely associated with presentations related to traumatic injury than to those related to toxicologic complications.
本调查的目的是记录急诊科（ED）中同时使用可卡因（COC）和乙醇（EtOH）检测呈阳性的患者的临床表现，以及该研究人群中可卡因乙烯酯（CE）形成的发生率。评估了四个研究组：（1）无药物组，（2）仅使用EtOH组，（3）仅使用COC组，以及（4）COC加EtOH组。在88%的COC/EtOH阳性患者的血浆或尿液样本中检测到CE，且与血浆COC及其代谢物苯甲酰芽子碱直接相关。各研究组间血压和体温无差异。COC/EtOH阳性患者的平均呼吸频率显著更高，而仅使用EtOH的研究组平均心率升高。研究组间在心脏和神经方面的主诉未检测到显著差异。药物阳性组的创伤主诉比无药物人群报告的发生率更高。COC/EtOH阳性患者的创伤主诉比例最高（34.6%）。近一半CE检测呈阳性的患者将创伤作为前往急诊科就诊的主要原因。我们得出结论，同时使用COC和EtOH的急诊科患者与创伤性损伤相关的表现比与毒理学并发症相关的表现联系更为紧密。
