急性自己中毒における複数の用量の活性炭:ランダム化制御試験
Michael Eddleston1, Edmund Juszczak, Nick A Buckley
1Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK. eddlestonm@yahoo.com
Lancet (London, England)
|February 19, 2008
まとめ
常用多用量活性炭は,アジア太平洋の農村で意図的な自己中毒による死亡率を低下させなかった. これらの地域では,殺虫剤と植物の摂取に対して,効率的で手頃な価格の治療が緊急に必要とされています.
科学分野:
- 毒理学 毒理学 毒理学
- 臨床毒理学 臨床毒理学とは
- 公共衛生は公衆衛生である.
背景:
- 意図的な自己中毒は,先進国と比較して開発途上国において,死亡率が著しく高い.
- この格差は,主に農村部の非常に有毒な農薬と植物の使用に起因する.
- この研究では,死亡率を下げるための潜在的な介入として活性炭を調査した.
研究 の 目的:
- 開発途上国の農村部で意図的な自己中毒による死亡率を低減する多重投与活性炭の有効性を評価する.
- 炭水化物を使用しない治療,一回投与活性炭,複数回投与活性炭の治療の結果を比較する.
主な方法:
- スリランカの3つの病院でオープンラベルのランダム化対照試験が行われました.
- 4632人の患者がランダムに割り当てられ,木炭を投与せず,50gの投与量1回,または4時間の間隔で50gの活性炭を6回投与された.
- 主なアウトカム指標は死亡率であり,治療の意図による分析が行われました.
主要な成果:
- 死亡率は,木炭を使用していないグループ (6.8%),単回投与 (6.3%) および複数回投与 (6.3%) の活性炭グループ間で有意な差異はなかった.
- 摂取した毒の種類,入院時の疾患の重症度,または発症時の時点で,アウトカムの有意な違いは観察されなかった.
- 炭を摂取しないグループと比較して,複数回投与グループにおける死亡率の調整された確率比は0.96 (95%CI 0.70-1.33) であった.
結論:
- アジア太平洋地域の農村部で故意の自己中毒のために,複数の用量の活性炭を日常的に使用することは推奨できません.
- 活性炭の早期投与に関するさらなる研究は有益かもしれません.
- これらの地域では,殺虫剤と植物の摂取に対する効果的で手頃な価格の治療法の開発が緊急に必要とされています.
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