A toxicokinetic analysis in a patient with acute glufosinate poisoning
A toxicokinetic analysis in a patient with acute glufosinate poisoning
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DOI：
10.1191/096032799678840110
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发表时间：
1999-05-01
影响因子：
2.8
通讯作者：
Kikuchi, M
中科院分区：
文献类型：
--
作者：
Hirose, Y;Kobayashi, M;Kikuchi, M
日本因摄入含草铵膦除草剂而引起的人体中毒事件逐渐增多。这种中毒的特点是在几个小时的无症状间隔后出现各种神经系统症状，例如意识障碍、抽搐和呼吸暂停。我们研究了一名未经体外血液净化成功治疗的中毒患者的草铵膦毒代动力学。一名 65 岁男性摄入 BASTA，其中含有 20% w/v 草铵膦，约 300 毫升，超过估计的人体中毒剂量。摄入后四个半小时，他出现言语共济失调和全身性震颤。在发生严重呼吸衰竭之前，他接受了预防性插管。人工通气5天后，他拔管出院，没有留下任何后遗症。我们每3-6小时研究血清草铵膦浓度的系列变化，并每24小时评估草铵膦的尿排泄。根据尿中累积排泄量估算草铵膦的吸收量。使用二室模型进行毒代动力学分析。血清草铵膦浓度的变化显示T-1/2α为1.84小时，T-1/2β为9.59小时。 β相的表观分布容积和全身清除率分别为1.44 l/kg和86.6 ml/min。肾清除率估计为 77.9 毫升/分钟。已经讨论了针对这种中毒进行体外血液净化的适应症。
Incidents of poisoning in humans caused by the ingestion of the glufosinate ammonium containing herbicides are gradually increasing in Japan. This poisoning is characterized by various neurological symptoms such as disturbances of consciousness, convulsions and apnea which appear after an asymptomatic interval of several hours. We studied the toxicokinetics of glufosinate in a patient with this poisoning successfully treated without extracorporeal hemopurification. A 65-year-old male ingested BASTA, which contains 20% w/v of glufosinate ammonium, about 300 ml, more than the estimated human toxic dose. Four and a half hours after ingestion, he showed speech ataxia and systemic tremor. He was prophylactically intubated before the occurrence of serious respiratory failure. After 5 days of artificial ventilation he was extubated and discharged without any sequelae. We studied the serial change of serum glufosinate concentration every 3-6 h and assessed the urinary excretion of glufosinate every 24 h. The absorbed amount of glufosinate was estimated from the cumulative excreted in urine. Toxicokinetic analysis was performed using the two-compartment model. The changes in serum glufosinate concentration exhibited T-1/2 alpha of 1.84 and T-1/2 beta of 9.59 h. The apparent distribution volume at beta-phase and the total body clearance were 1.44 l/kg and 86.6 ml/min, respectively. Renal clearance was estimated to be 77.9 ml/min. The indication for extracorporeal hemopurification for this poisoning has been discussed.