대한임상독성학회지 (Journal of The Korean Society of Clinical Toxicology)

  • 제16권2호
  • /
  • Pages.149-156
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  • 2018
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  • 1738-1320(pISSN)
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  • 2508-6332(eISSN)
대한임상독성학회 (Korean society of Clincal Toxicology)
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아세트아미노펜 중독 환자에서 간독성 발생 예측인자들의 유용성

Usefulness of Predictors for Hepatotoxicity in Acetaminophen Poisoning Patient

  • 김은영 (연세대학교 의과대학 응급의학교실) ;
  • 정성필 (연세대학교 의과대학 응급의학교실) ;
  • 고동률 (연세대학교 의과대학 응급의학교실) ;
  • 공태영 (연세대학교 의과대학 응급의학교실) ;
  • 유제성 (연세대학교 의과대학 응급의학교실) ;
  • 좌민홍 (연세대학교 의과대학 응급의학교실) ;
  • 김민정 (연세대학교 의과대학 응급의학교실)
  • Kim, Eun Young (Department of Emergency Medicine, Yonsei University College of Medicine) ;
  • Chung, Sung Phil (Department of Emergency Medicine, Yonsei University College of Medicine) ;
  • Ko, Dong Ryul (Department of Emergency Medicine, Yonsei University College of Medicine) ;
  • Kong, Tae Young (Department of Emergency Medicine, Yonsei University College of Medicine) ;
  • You, Je Sung (Department of Emergency Medicine, Yonsei University College of Medicine) ;
  • Choa, Min Hong (Department of Emergency Medicine, Yonsei University College of Medicine) ;
  • Kim, Min Joung (Department of Emergency Medicine, Yonsei University College of Medicine)
  • 투고 : 2018.06.29
  • 심사 : 2018.11.22
  • 발행 : 2018.12.31
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초록

Purpose: The purpose of this study was to determine whether hepatotoxicity could be predicted early using biochemical markers in patients with acetaminophen (AAP) poisoning and to assess the usefulness of predictive factors for acute liver injury or hepatotoxicity. Methods: This study was a retrospective observational study involving a medical records review. The participants were patients who were admitted to the emergency department (ED) with AAP overdose at two hospitals over a 10-year period. Demographic data, age, time from ingestion to visit, initial AAP level, initial hepatic aminotransferases, and initial prothrombin time were recorded. Acute liver injury was defined as a peak serum ALT >50 U/L or double the admission value, and hepatotoxicity was defined as a peak ALT >1,000 U/L. Receiver operating characteristic curve analyses were performed to compare the prognostic performance among variables. Results: A total of 97 patients were admitted to the ED with AAP overdose, of whom 26 had acute liver injury and 6 had hepatotoxicity. Acute liver injury was associated with the time interval after taking the drug, and hepatotoxicity was associated with the initial PT and the ALT level. The scoring system proposed by the authors has a significant ability to predict both acute liver injury and hepatotoxicity. Conclusion: To predict the prognosis of AAP poisoning patients, the time interval after taking AAP was important, and initial prothrombin time and ALT level were useful tests. Also a scoring system combining variables may be useful.

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참고문헌

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