Kowalczyk M, Halvorsen S, Ovrebo S, Bredesen J E, Jacobsen D
National Poisons Information Centre, Ullevaal University Hospital, Oslo, Norway.
Vet Hum Toxicol. 1998 Aug;40(4):225-8.
Two otherwise healthy 16-y-old female patients were treated with sodium bicarbonate and ethanol after the ingestion of unknown quantities of ethylene glycol. Patient 2 was admitted twice for ethylene glycol poisoning in unrelated events. In patient 1, the maximum levels of ethylene glycol and glycolate in plasma were 14 mmol/L (0.9 g/L) and 8.2 mmol/L (0.5 g/L), respectively. In patient 2, the maximum levels of ethylene glycol in plasma during the 2 admissions were 18 mmol/L (1.1 g/L) and 45 mmol (2.8 g/L), respectively. In patient 1, a blood ethanol concentration between 130-140 mg/dL (28-30 mmol/L) was reached 3 h after the start of ethanol administration and maintained for 22 h. During this period, ethylene glycol metabolism was effectively inhibited as indicated by S-glycolate levels and that 88% of the eliminated ethylene glycol was accounted for in the urine. This suggests that ethanol therapy alone may be sufficient for patients admitted early with low serum ethylene glycol concentrations. During the admissions of patient 2, the blood ethanol concentrations were presumed to effectively inhibit ethylene glycol metabolism as judged from normal acid/base parameters. However, during the second admission the bolus infusion of ethanol was associated with respiratory arrest. During both admissions for patient 2, hemodialysis constituted the major route of ethylene glycol elimination.
两名原本健康的16岁女性患者在摄入未知量的乙二醇后接受了碳酸氢钠和乙醇治疗。患者2因无关事件两次因乙二醇中毒入院。在患者1中，血浆中乙二醇和乙醇酸的最高水平分别为14 mmol/L（0.9 g/L）和8.2 mmol/L（0.5 g/L）。在患者2中，两次入院期间血浆中乙二醇的最高水平分别为18 mmol/L（1.1 g/L）和45 mmol/L（2.8 g/L）。在患者1中，乙醇给药开始后3小时血液乙醇浓度达到130 - 140 mg/dL（28 - 30 mmol/L）并维持22小时。在此期间，如S - 乙醇酸水平所示，乙二醇代谢被有效抑制，并且88%的已清除乙二醇在尿液中得到解释。这表明对于早期血清乙二醇浓度低的入院患者，单独乙醇治疗可能就足够了。在患者2入院期间，根据正常的酸碱参数判断，血液乙醇浓度被认为有效抑制了乙二醇代谢。然而，在第二次入院期间，乙醇的大剂量输注与呼吸骤停有关。在患者2的两次入院期间，血液透析是乙二醇清除的主要途径。
