Clinical implications of the ethane in exhaled breath in patients with acute paraquat intoxication
Clinical implications of the ethane in exhaled breath in patients with acute paraquat intoxication
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DOI：
10.1378/chest.128.3.1506
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发表时间：
2005-09-01
期刊：
影响因子：
9.6
通讯作者：
Kim, YH
中科院分区：
文献类型：
--
作者：
Hong, SY;Gil, HW;Kim, YH
研究目的：脂质过氧化导致的肺纤维化是百草枯中毒的主要症状。呼气中的乙烷（exEth）反映了脂质过氧化反应，并可能是急性肺损伤中氧自由基损伤的一个指标。本研究的目的，是评估的临床疗效exEth作为一种措施，暴露于百草枯和作为一个指标的肺damage.Design：暴露水平进行了评估摄入量，半定量测量尿液百草枯水平，和血浆百草枯浓度。在百草枯摄入后24 h收集潮气末呼吸用于测量乙烷。在呼吸采集当天进行肾功能和血气分析，最终临床结局定义为恢复或死亡。研究对象：2001 ~ 2002年21例百草枯中毒患者。结果：exEth不能作为Pao（2）、Paco（2）、血肌酐和肺损伤（高分辨率CT分级）等实验室指标的预测因子。逻辑分析显示，只有百草枯摄入量是死亡率的重要预测因子（p = 0.021）。exEth和死亡率之间的关联的强度是不受额外的或潜在的混杂因素，如年龄，性别，时间间隔和百草枯concentration.Conclusion：exEth不能被用作一个独立的预测生存或肺损伤的患者急性百草枯中毒的特异性标志物。
Study objectives: Pulmonary fibrosis due to lipid peroxidation is a major symptom of paraquat intoxication. Ethane in the expired breath (exEth) reflects lipid peroxidation and may be a measure of the damage effected by oxygen radicals in acute lung injury. The purpose of this study, was to evaluate the clinical efficacy of exEth as a measure of exposure to paraquat and as an indicator of lung damage.Design: Exposure levels were evaluated by the amount ingested, semiquantitative measurement of urine paraquat levels, and plasma paraquat concentration. End-tidal breath was collected for measurement of ethane 24 h after paraquat ingestion. Renal function and blood gas analyses were conducted,on the same day as the breath collection, and the final clinical outcome was defined as either recovery or death. Associations between exEth and paraquat exposure profiles and clinical outcomes were assessed using linear regression models.Patients: Twenty,one patients poisoned by, paraquat were selected for the study during 2001 and 2002.Results: exEth could not be used as a predictor of laboratory parameters such as Pao(2), Paco(2), serum creatinine, and lung injury (as graded by, high-resolution CT). A logistical anaylsis revealed that only the amount of paraquat ingested was a significant predictor of fatality (p = 0.021). The strength of the association between exEth and fatality was unaffected by the addition or potential confounders such as age, sex, and time interval and paraquat concentration.Conclusion: exEth cannot be used as either an independent predictor of survival or a specific marker of lung injury in patients with acute paraquat poisoning.