Treatment of diazepam intoxication with lipid emulsion: clinical study
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摘要: 目的 观察脂肪乳对地西泮中毒患者疗效及血药浓度的影响.方法 26例重度地西泮中毒患者按中毒严重程度大致接近原则,分为氟吗西尼组(单纯氟吗西尼治疗,9例);10%脂肪乳组(氟吗西尼+10%脂肪乳250 mL治疗,9例);20%脂肪乳组(氟吗西尼+20%脂肪乳250 mL治疗,8例).比较各组间治疗前、后不同时间点(治疗后1、10和20 h)血液地西泮浓度以及病人住院时间、氟吗西尼总用量差异.结果 治疗前各组地西泮血药浓度差异无统计学意义(P>0.05),治疗后不同时间点各组间地西泮血药浓度比较差异均有统计学意义(P=0.000),两个脂肪乳组血药浓度均明显低于单纯氟吗西尼组.其中治疗后1h,20%脂肪组明显低于10%脂肪乳组[(1 952.3±837.4) ng/mL、(2 428.9±1149.3) ng/mL,P=0.033];治疗后10 h和20 h 10%脂肪乳组与20%脂肪乳组浓度差异无统计学意义[(1 786.9±899.4) ng/mL、(1 359.1±665.6) ng/mL,P>0.05;(1 362.1±792.1) ng/mL、(1 090.5±638.4) ng/mL,P>0.05].氟吗西尼总用量组间比较,差异有统计学意义(P=0.000).氟吗西尼组(3.33±0.80) mg与10%脂肪乳组(2.26±0.36) mg及20%脂肪乳组(1.91±0.29) mg相比,差异均有统计学意义(P=0.000).住院时间组间比较,差异有统计学意义(F=20.594,P=0.000).氟吗西尼组(5.23±1.23)d与10%脂肪乳组(3.60±0.80)d及20%脂肪乳组(2.50±0.58)d差异均有统计学意义(P=0.000);10%脂肪乳组与20%脂肪乳组差异有统计学意义(P=0.017).结论 脂肪乳可在短时间内降低地西泮血药浓度,减少中毒患者氟吗西尼用量,缩短住院时间,是地西泮或其他脂溶性药物中毒的潜在解毒剂.
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Grant Cave, Martyn harvey, Andis graudins. Review article:Intravenous lipid emulsion as antidote:A summary of published human experience [J]. Emergency medicine Australasia, 2011.123.doi: 10.1111/j.1742-6723.2011.01398.x. Jamaty C, Bailey B, Larocque A. Lipid emulsions in the treatment of acute poisoning:a systematic review of human and animal studies [J]. Clin Toxicol (Phila), 2010(1):1.doi: 10.3109/15563650903544124. 周丹, 孟新科, 郑晓英. 脂肪乳对地西泮中毒患者血液浓度影响的临床观察 [J]. 中国急救医学, 2011, (11):1021.doi: 10.3969/j.issn.1002-1949.2011.11.016. Weinberg G L, VadeBoncouer T, Ramaraju G A. Pretreatment or resuscitation with a lipid infusion shifts the dose response to bupivacaine-induced asystole in rats [J]. Anesthesiology, 1998.1071.doi: 10.1097/00000542-199804000-00028. Weinberg G L. Intravenous lipid emulsion:why wait to save a life [J]. Emergency Medicine Australasia, 2011(2):113.doi: 10.1111/j.1742-6723.2011.01400.x. Litz R J, Roessel T, Heller A R. Reversal of central nervous system and cardiac toxicity after local anesthetic intoxicationby lipid emulsion injection [J]. Anesthesia and Analgesia, 2008, (5):1575.doi: 10.1213/ane.0b013e3181683dd7. 陈彤, 崔明晓. 血液灌流治疗重度安定中毒11例 [J]. 山东医药, 2005(2):23.doi: 10.3969/j.issn.1002-266X.2005.02.056. French D, Armenian P, Ruan W. Serum verapamil concentrations before and after Intralipid therapy during treatment of an overdose [J]. Clin Toxicol (Phila), 2011(4):340.doi: 10.3109/15563650.2011.572556. Wang Q G, Liu L, Xu X Z. Effects of lipid emulsion on hemodynamics and pharmacokinetics of mongrel dogs with bupivacaine-induced cardiac depression [J]. 中华医学杂志, 2009, (25):1787.doi: 10.3760/cma.j.issn.0376-2491.2009.25.017.
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