的临床意义是什么5-oxoproline (pyroglutamic酸)在高阴离子间隙代谢性酸中毒后扑热息痛(对乙酰氨基酚)接触?
文章的细节
-
引用
复制到剪贴板 -
丽丝DB,派登女士,施瓦兹,马林斯我
的临床意义是什么5-oxoproline (pyroglutamic酸)在高阴离子间隙代谢性酸中毒后扑热息痛(对乙酰氨基酚)接触?
中国Toxicol(费拉)。2013年11月,51(9):817 - 27所示。doi: 10.3109 / 15563650.2013.844822。Epub 2013年10月11日。
- PubMed ID
-
24111553 (在PubMed]
- 文摘
-
背景:扑热息痛(对乙酰氨基酚)摄入是最常见的药物过量在发达世界。代谢性酸中毒有时发生,但很少持续或严重酸中毒。越来越多的案例报告和案例系列描述高阴离子间隙代谢性酸中毒(HAGMA)与后续的检测或测量5-oxoproline扑热息痛曝光后(也称为pyroglutamic酸)在血液,尿液,或两者兼而有之。通常5-oxoprolinuria或5-oxoprolinemia先天遗传的设置错误发生在谷胱甘肽代谢。还不知道5-oxoprolinemia扑热息痛曝光设置的反映了收购或瞬态错乱的谷胱甘肽代谢或以前未识别的遗传缺陷。目的:我们回顾了出版5-oxoprolinemia或5-oxoprolinuria HAGMA患者中扑热息痛的设置曝光。我们的目标是识别出任何一致的特性,可能会增加我们的理解病理生理学的类似病例的诊断和治疗。方法:我们搜查了医学文献必威国际app使用PUBMED和EMBASE从开始到2013年8月28日应用搜索条件(“oxoproline”或“pyroglutamic酸”和“扑热息痛”或“对乙酰氨基酚”)。这两个搜索返回的交集77篇文章,其中64涉及人类受试者和英语必威国际app。两篇文章,分别在西班牙和荷兰,综述。 An additional Google Scholar search was done with the same terms. We manually searched the reference lists of retrieved articles to identify additional four relevant articles. We focused on articles including measured 5-oxoproline concentrations in urine or blood. RESULTS: Twenty-two articles included quantified 5-oxoproline concentrations. Several additional articles mentioned only qualitative detection of 5-oxoproline in urine or blood without concentrations being reported. Our manual reference search yielded four additional articles for a total of 24 articles describing 43 patients with quantified 5-oxoproline concentrations. The cases varied widely in paracetamol dose, duration and circumstances of paracetamol exposure, presence, and degree of elevation in transaminase activities, and when reported observed blood, serum, or urine 5-oxoproline concentrations. Concomitant use of flucloxacillin, another medication associated with oxoprolinemia or oxoprolinuria, confounded several of the cases. No clear dose-response relationship existed between the quantity of paracetamol ingested and the observed concentrations of 5-oxoproline. Clinical outcomes, including mortality, varied with no clear relationship to 5-oxoproline concentrations. CONCLUSIONS: In rare cases, HAGMA in the setting of paracetamol exposure is attributable to 5-oxoprolinemia. Clinicians should first exclude commoner and treatable causes of HAGMA, such as lactic acidosis, co-ingested drug administration, and ketoacidosis. It is likely that the propensity for HAGMA following paracetamol exposure may be genetically determined. The effects of acetylcysteine on 5-oxoproline concentrations or clinical outcome are unknown. When HAGMA is diagnosed, the 5-oxoproline concentration and the glutathione synthetase activity should be measured.
DrugBank数据引用了这篇文章
- 药物