Acute paraquat poisoning - Report of a survival case following intake of a potential lethal dose
Acute paraquat poisoning - Report of a survival case following intake of a potential lethal dose
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DOI：
10.1097/01.pec.0000223179.07633.8a
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发表时间：
2006-07-01
影响因子：
1.4
通讯作者：
Carvalho, Felix
中科院分区：
文献类型：
--
作者：
Dinis-Oliveira, Ricardo J.;Sarmento, Antonio;Carvalho, Felix
如果使用得当，百草枯(PQ)是一种广泛使用的联吡啶除草剂，具有良好的安全记录。大多数PQ中毒是由故意摄入造成的，在中到重度中毒中，肺纤维化继发于低氧血症导致死亡。高摄入量(>；50毫升20%重量/体积的配方)，中毒后一周内死于多器官衰竭和心血管衰竭。本报告描述了一起成功的临床案例，涉及一名15岁女孩被推定致死剂量的PQ中毒。青少年摄入了大约50毫升商业化浓缩(20%重量/体积的二氯盐)的PQ配方。血、尿PQ升高证实预后不良。然而，在本临床病例中遵循的治疗方案导致了积极的结果。除了减少PQ吸收和增加其清除的措施外，还采用了其他保护措施，目的是减少ROS的产生，清除ROS，修复ROS引起的损伤，减少炎症。还介绍了PQ中毒的生物化学和毒理学方面的最新研究现状，以及相应治疗的药理学基础。
When properly used, paraquat (PQ) is a widely used bipyridil herbicide with a good safety record. Most cases of PQ poisoning result from intentional ingestion, with death resulting from hypoxemia secondary to lung fibrosis in moderate to severe poisonings. With high ingestion volumes (> 50 mL of a 20% wt/vol formulation), death results from multiple organ failure and cardiovascular collapse within 1 week after intoxication. The present report describes a successful clinical case regarding the intoxication of a 15-year-old girl by a presumed lethal dose of PQ. The adolescent ingested approximately 50 mL of a commercialized concentrate (20% wt/vol of dichloride salt) formulation of PQ. High serum and urinary levels of PQ confirmed the bad prognosis. However, the therapeutic protocol followed in the present clinical case led to a positive outcome. Besides the measures for decreasing PQ absorption and increasing its elimination, other protective procedures were applied in aiming to reduce the production of reactive oxygen species (ROS), to scavenge ROS, to repair ROS-induced lesions, and to reduce inflammation. The status-of-the-art concerning the biochemical and toxicological aspects of PQ poisoning and the pharmacologic basis of the respective treatment is also presented.