Study of Prognosis Index in Patients with Acute Arsenic Trihydride Poisoning_West China Medical Journal

Authors：

 IELin-shen , ZHOUDing-zi , ZENGZheng ,  ZHUQi-shang

Department of Occupational Disease and Toxicity, No.4 West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

ZHUQi-shang, Email: zqs0804@sina.com

Keywords：

Arsenic trihydride; Poisoning; Prognosis

DOI：

10.7507/1002-0179.20140312

Video：

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Objective To observe the prognosis index in acute arsenic trihydride poisoning patients in order to provide references for early clinical treatment. Methods We retrospectively analyzed the clinical data of 20 acute arsenic trihydride poisoning patients treated between July 2010 and January 2014. The patients were divided into death group and survival group according to survival situation 90 days later. The length of time from onset to treatment, urine arsenic concentration, blood routine, hepatic and renal function, electrolyte, myocardial enzyme, arterial blood gas analysis were observed by single factor analysis, and the positive indexes were analyzed by logistic regression analysis to seek the potential influencing factors for survival. Results Compared with the survival group, the length of time from onset to treatment, urine arsenic, serum total bilirubin, creatinine, creatine kinase of the death group were significantly higher (P<0.05), while the value of pH, HCO₃^-, BE of the survival group were significantly lower (P<0.05). Logistic regression analysis revealed that these indexes remarkably affected patients' survival rate. Conclusion Therapeutic time window, extent of damage of heart, liver, kidney and acid-base imbalance are closely associated with the survival rate of arsenic trihydride poisoning patients, and timely treatment for above factors can be useful for improving prognosis.

Citation： IELin-shen, ZHOUDing-zi, ZENGZheng, ZHUQi-shang. Study of Prognosis Index in Patients with Acute Arsenic Trihydride Poisoning. West China Medical Journal, 2014, 29(6): 1022-1024. doi: 10.7507/1002-0179.20140312 Copy

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10.	路愛麗, 齊振普. 急性重度砷化氫中毒2例相關檢驗指標分析[J]. 國際檢驗醫學雜志, 2013, 34(12): 1608-1610.
11.	陳真英. 血漿置換加連續性血液凈化治療急性砷化氫中毒并發MODS[J]. 中國現代醫藥雜志, 2008, 10(7): 67-68.
12.	Pakulska D, Czerczak S. Hazardous effects of arsine: a short review[J]. Int J Occup Med Environ Health, 2006, 19(1): 36-44.
13.	萬芳, 王琳, 馬五一, 等. 急性砷化氫中毒并發急性血管內溶血、DIC、ARF的臨床分析[J]. 中國工業醫學雜志, 2008, 21(5): 301-303.
14.	楊春燕, 段宇珠, 趙群遠, 等. 急性砷化氫中毒并發急性胰腺炎5例分析[J]. 中外醫學研究, 2013, 11(9): 108-109.
15.	孫德興, 李曉鳳, 譚河清, 等. 10例急性重度砷化氫中毒心肌損害臨床分析[J]. 工業衛生與職業病, 2009, 35(5): 302-303.
16.	樊華, 孫德興, 李法鵬, 等. 血液透析聯合血液灌流治療急性重度砷化氫中毒臨床分析[J]. 中國工業醫學雜志, 2012, 25(4): 265-266.
17.	Pullen-James S, Woods SE. Occupational arsine gas exposure[J]. J Natl Med Assoc, 2006, 98(12): 1998-2001.
18.	彭靜, 辜江. 急性砷化氫中毒合并中毒性心肌炎25例臨床分析[J]. 中國實用醫藥, 2009, 4(8): 84-85.
19.	李森林, 李靜華, 張智剛. 急性砷化氫中毒對膽道系統的影響[J]. 中華勞動衛生職業病雜志, 2002, 20(1): 64-65.

1. 中華人民共和國衛生部. GBZ 44-2002職業性急性砷化氫中毒診斷標準[S]. 北京: 中國標準出版社, 2002.
2. 黎海紅, 黃世文, 張振明. 一起因銦冶煉引起的砷化氫急性中毒事故調查分析[J]. 職業衛生與應急救援, 2012, 30(5): 255-256.
3. 陳維平, 牛秋雅, 田一莊, 等. 銦生產過程中AsH_3氣體污染治理的研究[J]. 環境工程, 2002, 20(5): 31-33.
4. 李岳, 王庚. 銦作業致急性砷化氫中毒的調查分析[J]. 工業衛生與職業病, 2007, 33(3): 191.
5. 張智剛, 盧杰, 李森林. 血漿置換加血液透析治療急性砷化氫中毒并多器官功能障礙綜合征[J]. 中國血液凈化, 2006, 5(6): 347-348.
6. 劉麗萍, 覃震暉, 朱寧. 42例職業性急性砷化氫中毒對心臟損害臨床觀察[J]. 中國職業醫學, 2012, 39(1): 31-32.
7. 包維華. 急性砷化氫中毒患者肝腎功能動態變化[J]. 廣西醫科大學學報, 2013, 30(2): 261-263.
8. Rael LT, Ayala-Fierro F, Bar-Or R, et al. Interaction of arsine with hemoglobin in arsine-induced hemolysis[J]. Toxicol Sci, 2006, 90(1): 142-148.
9. Zhang L, Zhang Y, Lin Q, et al. Acute kidney injury, hematuria, and orange skin pigmentation caused by arsine poisoning[J]. Am J Kidney Dis, 2008, 52(8): A33-A36.
10. 路愛麗, 齊振普. 急性重度砷化氫中毒2例相關檢驗指標分析[J]. 國際檢驗醫學雜志, 2013, 34(12): 1608-1610.
11. 陳真英. 血漿置換加連續性血液凈化治療急性砷化氫中毒并發MODS[J]. 中國現代醫藥雜志, 2008, 10(7): 67-68.
12. Pakulska D, Czerczak S. Hazardous effects of arsine: a short review[J]. Int J Occup Med Environ Health, 2006, 19(1): 36-44.
13. 萬芳, 王琳, 馬五一, 等. 急性砷化氫中毒并發急性血管內溶血、DIC、ARF的臨床分析[J]. 中國工業醫學雜志, 2008, 21(5): 301-303.
14. 楊春燕, 段宇珠, 趙群遠, 等. 急性砷化氫中毒并發急性胰腺炎5例分析[J]. 中外醫學研究, 2013, 11(9): 108-109.
15. 孫德興, 李曉鳳, 譚河清, 等. 10例急性重度砷化氫中毒心肌損害臨床分析[J]. 工業衛生與職業病, 2009, 35(5): 302-303.
16. 樊華, 孫德興, 李法鵬, 等. 血液透析聯合血液灌流治療急性重度砷化氫中毒臨床分析[J]. 中國工業醫學雜志, 2012, 25(4): 265-266.
17. Pullen-James S, Woods SE. Occupational arsine gas exposure[J]. J Natl Med Assoc, 2006, 98(12): 1998-2001.
18. 彭靜, 辜江. 急性砷化氫中毒合并中毒性心肌炎25例臨床分析[J]. 中國實用醫藥, 2009, 4(8): 84-85.
19. 李森林, 李靜華, 張智剛. 急性砷化氫中毒對膽道系統的影響[J]. 中華勞動衛生職業病雜志, 2002, 20(1): 64-65.

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West China Medical Journal

Study of Prognosis Index in Patients with Acute Arsenic Trihydride Poisoning

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