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首页> 外文期刊>European journal of gastroenterology and hepatology >The administration of N-acetylcysteine causes a decrease in prothrombin time in patients with paracetamol overdose but without evidence of liver impairment.
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The administration of N-acetylcysteine causes a decrease in prothrombin time in patients with paracetamol overdose but without evidence of liver impairment.

机译：N-乙酰半胱氨酸的使用导致扑热息痛过量但无肝功能损害患者的凝血酶原时间减少。

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OBJECTIVE: To explore the effect of intravenous N-acetylcysteine (NAC) on the prothrombin time (PT) in patients with paracetamol overdose and persistent normal liver profile. MATERIALS AND METHODS: This retrospective case series study examined all admissions with a diagnosis of paracetamol poisoning in a tertiary hospital between 1989 and 2002. Patients were included if they had ever received NAC infusion, had no biochemical evidence of liver damage, and had more than two measurements of PT. Patients who had also ingested other drugs were excluded. RESULTS: Of 65 admissions wtih paracetamol poisoning, 18 patients (10 men) met the inclusion criteria. The median age was 29 years, and the median quantity of paracetamol ingested was 186 mg/kg. The mean number of PT measurements per patient was 4.8. The baseline PT (as a percentage) 8.6 h after paracetamol ingestion was 89.6%. During NAC infusion the PT fell in all patients (range, 4.8-53.4% relative to baseline; P < 0.0001) at 14 h. The PT was less than 60% in 28% of the patients. Eight hours after the initiation of NAC there was a 16% fall in PT (range, 4.3-34%; P < 0.0001). At the end of NAC infusion all PTs returned to values close to baseline. Nine patients were hospitalized. CONCLUSIONS: In patients with paracetamol overdose without evidence of liver damage a marked decrease in PT often occurs, which seems to be due to the overload of NAC infused at the beginning of treatment. This particular feature should be noted in clinical practice guidelines as a potentially misleading indicator of the development of severe liver dysfunction.
机译：目的：探讨静脉内N-乙酰半胱氨酸（NAC）对对乙酰氨基酚过量和持续正常肝功能的患者凝血酶原时间（PT）的影响。材料与方法：这项回顾性病例系列研究检查了1989年至2002年间一家三级医院中所有诊断为对乙酰氨基酚中毒的入院患者。如果患者曾接受过NAC输注，无肝损伤的生化证据且超过PT的两次测量。同时摄入其他药物的患者也被排除在外。结果：在对乙酰氨基酚中毒的65例入院病例中，有18例（10例男性）符合纳入标准。中位年龄为29岁，对乙酰氨基酚的中位摄入量为186 mg / kg。每位患者的PT测量平均值为4.8。扑热息痛摄入后8.6小时的基线PT（以百分比计）为89.6％。在NAC输注期间，所有患者的PT在14小时均下降（范围，相对于基线为4.8-53.4％; P <0.0001）。 28％的患者中PT低于60％。 NAC启动后八小时，PT下降了16％（范围4.3-34％; P <0.0001）。 NAC输注结束时，所有PT均返回接近基线的值。九名患者住院。结论：在对乙酰氨基酚过量的患者中，没有肝损害的证据，通常会出现PT的明显下降，这似乎是由于治疗开始时注入的NAC过多所致。该特殊功能应在临床实践指南中作为严重肝功能障碍发展的潜在误导性指标加以说明。

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