• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>The Internet Journal of Toxicology >Profile Of Hepatotoxicity In Current Toxicology Practice In Egypt
【24h】

Profile Of Hepatotoxicity In Current Toxicology Practice In Egypt

机译：埃及当前毒理学实践中的肝毒性概况

获取原文
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

BACKGROUND: The clinical review aimed to determine the characteristics and clinical profile of poison induced liver injury in the current clinical toxicology practice in Poison Control Center, Ain Shams University Hospitals.METHODS: During the period between July 1st 2009 and 30th of June 2010, patients were clinically assessed and reviewed for liver tests. All known hepatotoxins were included in the review whether liver injury resulted or not.RESULTS: Phosphides and organophosphate were the commonest causes of hepatotoxicity. Frequency of liver toxicity was significantly higher in paraphenylenediamine, methanol and lead poisoning. Concomitant renal insufficiency was significantly more common in shock. Shock was significantly more frequent in patients who had liver impairment than in patients with normal liver function.Mortality patients in the liver impairment group, manifested significantly higher frequency of metabolic and respiratory acidosis than in survivors. Death was significantly correlated with liver impairment and in renal insufficiency only in shock states.CONCLUSION: Antidotes protected against toxic hepatitis. Serious fulminant hepatitis with or without shock were the most serious outcome of phosphides intoxication. Mortality was correlated to liver or renal impairment only in shock states. Factors carrying bad prognosis include shock, renal insufficiency, metabolic and respiratory acidosis as concomitant clinical features. Recovery from toxic hepatitis was the rule in 97 out of 124 patients (78.2%) Introduction Acute poisoning with hepatotoxic drugs and poisons are a major common cause of liver injury. The commonest poisons involved in the daily toxicology practice in Poison Control center Ain Shams University include acetaminophen, iron, phosphorus and phosphide. Other less common toxins include alcohol, organophosphates insecticides, PPD (Paraphenylenediamine), phenytoin and other antiepileptic.Although drug-related hepatotoxicity is uncommon its true incidence is difficult to determine. Larrey [1] reported the incidence for many drugs, as between 1 in 10,000 and 1 in 100,000 patients. The numbers may be much higher, because of underreporting, difficulties in detection or diagnosis, and incomplete observation of persons exposed [2].This review aims to outline the profile of hepatotoxicity in Egypt in acute setting, describe the different presentations and define the prognostic factors Methods All cases received in Poison Control Center Ain Shams University were retrospectively reviewed by multiple reviewers for hepatotoxicity and for drugs known to induce toxic liver injury in the period between 1st of July 2009 until 30th of June 2010 are as well included in the review.The severity of liver cell damage is assessed by serial measurement of serum total bilirubin, albumin, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) and prothrombin time [3, 4]. Drug-related hepatotoxicity has been considered when typical symptoms occur in conjunction with biochemical evidence of liver injury. Rising transaminases from normal values on admission (day 1), over the following 2 – 3 days of poisoning event as well as regression on recovery from poisoning were recorded. Other associated laboratory findings included decrease of serum albumin and prolongation of prothrombin time (or its international normalized ratio INR) [2]. Liver toxicity was correlated to the offending agent by confirmed screening for phosphides, iron, valproate, carbamazepine, theophylline, CO, methanol or acetaminophen toxic blood levels, and erythrocyte and plasma cholinesterase levels suggestive of organophosphate poisoning.Cases with positive chronic liver diseases, or acute viral etiology were excluded from this review.Frequency of hepatotoxicity was statistically calculated using Chi square. Complications and clinical outcome were statistically analyzed using correlation coefficient. Results Hepatotoxic reactions ranging from mild to s
机译：背景：临床研究旨在确定目前在Ain Shams University Hospitals毒物控制中心临床毒理学实践中中毒诱发的肝损伤的特征和临床特征。方法：在2009年7月1日至2010年6月30日期间，患者经过临床评估并进行了肝检查。无论是否引起肝损伤，所有已知的肝毒素都包括在本评价中。结果：磷和有机磷酸酯是最常见的肝毒性原因。对苯二胺，甲醇和铅中毒的肝毒性发生率明显更高。伴有肾功能不全在休克中更为常见。肝功能不全患者的休克发生频率明显高于肝功能正常的患者。肝功能不全组的死亡患者的代谢和呼吸性酸中毒发生频率明显高于幸存者。死亡仅与休克状态下的肝功能损害和肾功能不全显着相关。结论：解毒剂可预防中毒性肝炎。严重的暴发性肝炎伴或不伴休克是磷化物中毒的最严重结果。死亡率仅在休克状态下与肝或肾损害相关。预后不良的因素包括休克，肾功能不全，代谢和呼吸性酸中毒为伴随的临床特征。 124名患者中有97名（78.2％）是从毒性肝炎中恢复的准则。简介肝毒性药物和毒物引起的急性中毒是肝损伤的主要常见原因。 Ain Shams大学毒物控制中心的日常毒理学操作中涉及的最常见的毒物包括对乙酰氨基酚，铁，磷和磷。其他较不常见的毒素包括酒精，有机磷酸酯杀虫剂，PPD（对苯二胺），苯妥英钠和其他抗癫痫药。尽管与药物相关的肝毒性并不常见，但其真正发生率却难以确定。 Larrey [1]报告了许多药物的发病率，在10,000例患者中有1例与100,000例患者中有1例之间。由于报道不足，检测或诊断困难以及对暴露者的观察不完全，该数字可能更高[2]。这篇综述旨在概述埃及急性环境中的肝毒性概况，描述不同的表现并确定预后因素方法在2009年7月1日至2010年6月30日期间，由多位审阅者对所有在Ain Shams大学毒物控制中心收到的病例的肝毒性和已知引起毒性肝损伤的药物进行了回顾性审查。肝细胞损伤的严重程度通过血清总胆红素，白蛋白，丙氨酸氨基转移酶（ALT）和天冬氨酸氨基转移酶（AST）和凝血酶原时间的连续测量来评估[3，4]。当典型症状与肝损伤的生化证据一起出现时，已考虑了与药物相关的肝毒性。记录入院后（第1天）转氨酶从正常值升高，随后的2-3天中毒事件以及中毒恢复后的回归。其他相关的实验室检查结果包括血清白蛋白降低和凝血酶原时间延长（或其国际标准化比率INR）[2]。通过确认筛查的磷化物，铁，丙戊酸盐，卡马西平，茶碱，CO，甲醇或对乙酰氨基酚中毒血液水平以及暗示有机磷酸酯中毒的红细胞和血浆胆碱酯酶水平，可以将肝脏毒性与违规药物相关联。本评价不包括急性病毒性病因。使用卡方统计地计算肝毒性的发生率。使用相关系数对并发症和临床结果进行统计学分析。结果肝毒性反应从轻度到中度

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号