INTRAVENOUS N-ACETYLCYSTEINE - TREATMENT OF CHOICE FOR PARACETAMOL POISONING
INTRAVENOUS N-ACETYLCYSTEINE - TREATMENT OF CHOICE FOR PARACETAMOL POISONING
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DOI：
10.1136/bmj.2.6198.1097
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发表时间：
1979-01-01
影响因子：
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通讯作者：
PROUDFOOT, AT
中科院分区：
文献类型：
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作者：
PRESCOTT, LF;ILLINGWORTH, RN;PROUDFOOT, AT
采用n -乙酰半胱氨酸（acetyl-半胱氨酸）静脉注射治疗100例重度扑热息痛中毒。40例患者在摄入后8小时内接受治疗（平均最大血清丙氨酸转氨酶活性27 IU/1），几乎完全防止肝损伤。在10小时内接受治疗的62例患者中只有1例发生严重肝损害，而回顾性研究的57例患者中有33例（58%）单独接受支持性治疗。早期治疗和使用乙酰半胱氨酸也能预防肾功能损害和死亡。完全防止严重肝损伤的关键摄入-治疗间隔为8小时。此后疗效逐渐下降，治疗15小时后完全无效。静脉注射乙酰半胱氨酸比半胱胺和蛋氨酸更有效，且明显无不良反应。这是扑热息痛中毒的首选治疗方法。
One hundred cases of severe paracetamol poisoning were treated with intravenous N-acetylcysteine (acetyl-cysteine). There was virtually complete protection against liver damage in 40 patients treated within eight hours after ingestion (mean maximum serum alanine transaminase activity 27 IU/1). Only one out of 62 patients treated within 10 hours developed severe liver damage compared with 33 out of 57 patients (58%) studied retrospectively who received supportive treatment alone. Early treatment and acetylcysteine also prevented renal impairment and death. The critical ingestion-treatment interval for complete protection against severe liver damage was eight hours. Efficacy diminished progressively thereafter, and treatment after 15 hours was completely ineffective. Intravenous acetylcysteine was more effective than cysteamine and methionine and noticeably free of adverse effects. It is the treatment of choice for paracetamol poisoning.