马基酸盐中毒:临床诊断与实验室发现对比
Didrik Skjelland1,2, Benedicte M Jørgenrud3, Karsten Gundersen4
1Department of General Practice, University of Oslo, Oslo, Norway.
Clinical toxicology (Philadelphia, Pa.)
|April 24, 2025
概括
临床诊断的马基酸盐中毒往往是不准确的,实验室测试证实它在三分之二的疑似病例中. 这表明,在紧急情况下,人们经常过度诊断马酸 (GHB) 中毒.
科学领域:
- 毒理学 毒理学 毒理学
- 紧急医疗 紧急医疗
- 临床化学 临床化学
背景情况:
- 马基酸盐 (GHB) 中毒呈现出多种症状和不稳定的意识,需要准确的诊断.
- 由于GHB中毒的异质表现和意识水平的波动,临床呈现可能具有挑战性.
研究的目的:
- 通过将其与实验室血液样本的发现进行比较,来评估马基酸盐中毒的临床诊断的准确性.
- 评估临床判断的可靠性,以确定在急诊室患者的马-基酸盐中毒.
主要方法:
- 16岁及以上患者的前性观察性研究,临床诊断为GHB中毒.
- 血液样本在入院时使用超高性能液体染色学-并联质谱法 (UHPLC-MS/MS) 进行分析.
主要成果:
- 在69.0%的患者 (60/87) 中检测到玛-氧丁酸盐.
- 检测GHB阳性的患者在格拉斯哥昏迷表得分明显较低 (P < 0.001) 和ICU入院率更高 (46.7%).
- 在GHB阳性患者中,同时服用其他药物 (安非他命,可卡因,二) 是常见的 (96.7%).
结论:
- 临床诊断GHB中毒可能导致过度诊断,因为GHB仅在约66%的疑似病例中得到确认.
- 经常同时摄入其他精神活性物质使疑似GHB中毒的临床诊断和治疗决策复杂化.
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