THE TEMPORAL PROFILE OF INCREASED TRANSAMINASE LEVELS IN PATIENTS WITH ACETAMINOPHEN-INDUCED LIVER DYSFUNCTION
THE TEMPORAL PROFILE OF INCREASED TRANSAMINASE LEVELS IN PATIENTS WITH ACETAMINOPHEN-INDUCED LIVER DYSFUNCTION
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DOI：
10.1016/s0196-0644(95)70237-7
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发表时间：
1995-07-01
影响因子：
6.2
通讯作者：
MOFENSON, HC
中科院分区：
文献类型：
--
作者：
SINGER, AJ;CARRACIO, TR;MOFENSON, HC
研究目的：人们经常认为，对乙酰氨基酚引起的肝功能障碍仅在潜伏期 24 至 48 小时后才会发生。本研究旨在评估对乙酰氨基酚引起的肝毒性患者的转氨酶水平的时间分布。设计：使用标准中毒控制中心数据表收集前瞻性数据。参与者：1993年1月至1994年6月期间向长岛中毒控制中心报告的接触对乙酰氨基酚的住院患者。摄入后24小时内就诊的患者以及住院期间天冬氨酸转氨酶（AST）水平升高的患者均包括在内在数据分析中。摄入后超过 24 小时、摄入过另一种潜在肝毒性药物或摄入对乙酰氨基酚超过 2 小时的患者被排除在外。 结果：在 1,825 名报告对乙酰氨基酚暴露的患者中，779 名存在潜在毒性摄入并在急诊室接受检查。入院的 291 名对乙酰氨基酚中毒患者中，有 36 名 (12%) 在住院期间的某个时间点 AST 水平升高。所有患者均在就诊后 2.5 小时内口服 N-乙酰半胱氨酸。在符合所有纳入标准的 19 名患者中，有 11 名 (58%) 的 AST 水平在摄入后 24 小时内升高。中位 AST 峰值水平为 422 IU/L（范围为 74 至 8,538 IU/L）。 4 名患者 (21%) 的 AST 水平在 48 小时内达到峰值，18 名患者 (95%) 的 AST 水平在 72 小时内达到峰值。 8 名 AST 峰值水平大于 1,000 IU/L 的患者中有 6 名在摄入对乙酰氨基酚后 24 小时内转氨酶水平升高。 结论：对乙酰氨基酚中毒可能导致摄入后 24 小时内血清转氨酶水平升高。
Study objective: it is often taught that acetaminophen-induced liver dysfunction occurs only after a latent period of 24 to 48 hours. This study was designed to evaluate the temporal profile of transaminase levels in patients with acetaminophen-induced hepatotoxicity.Design: Prospective data collection using standard poison control center data sheets.Participants: Hospitalized patients with acetaminophen exposure who were reported to the long Island Poison Control Center between January 1993 and June 1994. Patients who presented within 24 hours of ingestion and in whom increased aspartate aminotransferase (AST) levels developed during hospitalization were included in the data analysis. Patients who presented more than 24 hours after ingestion, who had ingested another potentially hepatotoxic agent, or who had ingested acetaminophen over a period of more than 2 hours were excluded.Results: Of 1,825 patients with reported acetaminophen exposure, 779 had potentially toxic ingestions and were examined in an emergency department. Of 291 patients with toxic acetaminophen levels who were admitted, 36 (12%) had increased levels of AST at some point during hospitalization. All received oral N-acetylcysteine within 2.5 hours of presentation. In 11 of 19 patients who met all inclusion criteria (58%), AST levels were noted to be increased in the 24 hours after ingestion. The median peak AST level was 422 IU/L (range, 74 to 8,538 IU/L). AST levels peaked within 48 hours in 4 patients (21 %) and within 72 hours in 18 patients (95%). Six of eight patients with peak AST levels greater than 1,000 IU/L had increased transaminase levels during the 24 hours after acetaminophen ingestion.Conclusion: Acetaminophen poisoning may cause the serum transaminase level to increase during the 24 hours after ingestion.