■磷化铝(AlP),被称为“米片”,“被广泛用作有效的农药。然而,AlP中毒是许多国家常见的死亡原因,比如伊朗。不幸的是,到目前为止,尚无针对AlP毒性的特定解毒剂。AlP在暴露于湿气或酸时释放磷化氢气体。膦是一种有效的线粒体毒素,可以显着抑制细胞能量代谢。AlP中毒是一种需要即时有效干预的紧急情况。二羟基丙酮(DHA)是一种简单的糖,用于多种药理和美容目的。以前,我们发现,在各种体外和体内实验模型中,DHA可以显著防止氰化物和磷化氢等毒性物质引起的线粒体损伤。
■对住院患者(n=111)进行了资格标准评估。在这些患者中,由于数据不完整(n=11)和怀疑AlP以外的中毒(n=24),排除了n=35例。同时,n=76例确诊的AlP中毒病例纳入研究。未接受DHA的AlP中毒患者(n=18)作为对照组。患者(n=58)接受至少一剂DHA(500毫升5%DHA溶液w/v,i.v.)作为AlP中毒的常规治疗之外的辅助治疗。动脉血气(ABG),血液pH值,碳酸氢盐水平,监测其他生命体征和生化指标。此外,对未给予DHA的DHA治疗和AlP中毒患者的死亡率和住院时间进行了评估.在DHA治疗之前(在住院时)和之后评估几种生物标志物。在这项研究中,对AlP中毒患者的常规测试是电解质(K和Na)的测量,WBC,红细胞,血红蛋白,INR,碳酸盐(HCO3),血液pH值,PaCO2、PaO2和SGPT,SGOT,BUN,Cr.
■患者入院时,血液pH值显著下降(酸中毒),血PaO2和HCO3水平是AlP中毒的标志。发现与基于医院常规AlP中毒方案(无DHA)治疗的患者相比,DHA显着减轻了AlP中毒的生物标志物,并大大提高了患者的生存率(DHA治疗组为65.52%,对照组为33.34%)。在本研究中,DHA治疗的患者没有明显的不良反应。
■这些数据表明,肠胃外DHA是一种新型有效的抗AlP中毒解毒剂,除常规支持治疗外,还可用作佐剂。
■IR.SUMS.REC.1394.102。
UNASSIGNED: Aluminum phosphide (AlP), known as \"rice tablet,\" is widely used as an effective pesticide. However, AlP poisoning is a common cause of mortality in many countries, such as Iran. Unfortunately, there is no specific antidote for AlP toxicity to date. AlP releases phosphine gas when it is exposed to moisture or acid. Phosphine is a potent mitochondrial toxin that could significantly inhibit cellular energy metabolism. AlP poisoning is an emergency condition that needs instant and effective intervention. Dihydroxyacetone (DHA) is a simple saccharide used for several pharmacological as well as cosmetic purposes. Previously, we found that DHA could significantly prevent mitochondrial impairment induced by toxic agents such as cyanide and phosphine in various in vitro and in vivo experimental models.
UNASSIGNED: Hospitalized patients (n = 111) were evaluated for eligibility criteria. Among these patients, n = 35 cases were excluded due to incomplete data (n = 11) and suspicion of poisoning with poisons other than AlP (n = 24). Meanwhile, n = 76 cases with confirmed AlP poisoning were included in the study. AlP-poisoned patients who did not receive DHA (n = 18) were used as the control group.Patients (n = 58) received at least one dose of DHA (500 ml of 5 % DHA solution w/v, i.v.) as an adjuvant therapy in addition to the routine treatment of AlP poisoning. Arterial blood gas (ABG), blood pH, bicarbonate levels, and other vital signs and biochemical measurements were monitored. Moreover, the mortality rate and hospitalization time were evaluated in DHA-treated and AlP-poisoned patients without DHA administration. Several biomarkers were assessed before (upon hospitalization) and after DHA treatment. The routine tests for AlP-poisoned patients in this study were the measurement of electrolytes (K+ and Na+), WBC, RBC, hemoglobin, INR, carbonate (HCO3), blood pH, PaCO2, and PaO2 and SGPT, SGOT, BUN, Cr.
UNASSIGNED: Upon patients\' admission, significant decreases in blood pH (acidosis), blood PaO2, and HCO3 levels were the hallmarks of AlP poisoning. It was found that DHA significantly alleviated biomarkers of AlP poisoning and tremendously enhanced patients\' survival rate (65.52 % in DHA-treated vs 33.34 % in the control group) compared to patients treated based on hospital routine AlP poisoning protocols (no DHA). No significant adverse effects were evident in DHA-treated patients in the current study.
UNASSIGNED: These data suggest that parenteral DHA is a novel and effective antidote against AlP poisoning to be used as an adjuvant in addition to routine supportive treatment.
UNASSIGNED: IR.SUMS.REC.1394.102.