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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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.	万芳, 王琳, 马五一, 等. 急性砷化氢中毒并发急性血管内溶血、DIC、ARF的临床分析[J]. 中国工业医学杂志, 2008, 21(5): 301-303.
14.	杨春燕, 段宇珠, 赵群远, 等. 急性砷化氢中毒并发急性胰腺炎5例分析[J]. 中外医学研究, 2013, 11(9): 108-109.
15.	孙德兴, 李晓凤, 谭河清, 等. 10例急性重度砷化氢中毒心肌损害临床分析[J]. 工业卫生与职业病, 2009, 35(5): 302-303.
16.	樊华, 孙德兴, 李法鹏, 等. 血液透析联合血液灌流治疗急性重度砷化氢中毒临床分析[J]. 中国工业医学杂志, 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.	彭静, 辜江. 急性砷化氢中毒合并中毒性心肌炎25例临床分析[J]. 中国实用医药, 2009, 4(8): 84-85.
19.	李森林, 李静华, 张智刚. 急性砷化氢中毒对胆道系统的影响[J]. 中华劳动卫生职业病杂志, 2002, 20(1): 64-65.

1. 中华人民共和国卫生部. GBZ 44-2002职业性急性砷化氢中毒诊断标准[S]. 北京: 中国标准出版社, 2002.
2. 黎海红, 黄世文, 张振明. 一起因铟冶炼引起的砷化氢急性中毒事故调查分析[J]. 职业卫生与应急救援, 2012, 30(5): 255-256.
3. 陈维平, 牛秋雅, 田一庄, 等. 铟生产过程中AsH_3气体污染治理的研究[J]. 环境工程, 2002, 20(5): 31-33.
4. 李岳, 王庚. 铟作业致急性砷化氢中毒的调查分析[J]. 工业卫生与职业病, 2007, 33(3): 191.
5. 张智刚, 卢杰, 李森林. 血浆置换加血液透析治疗急性砷化氢中毒并多器官功能障碍综合征[J]. 中国血液净化, 2006, 5(6): 347-348.
6. 刘丽萍, 覃震晖, 朱宁. 42例职业性急性砷化氢中毒对心脏损害临床观察[J]. 中国职业医学, 2012, 39(1): 31-32.
7. 包维华. 急性砷化氢中毒患者肝肾功能动态变化[J]. 广西医科大学学报, 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. 路爱丽, 齐振普. 急性重度砷化氢中毒2例相关检验指标分析[J]. 国际检验医学杂志, 2013, 34(12): 1608-1610.
11. 陈真英. 血浆置换加连续性血液净化治疗急性砷化氢中毒并发MODS[J]. 中国现代医药杂志, 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. 万芳, 王琳, 马五一, 等. 急性砷化氢中毒并发急性血管内溶血、DIC、ARF的临床分析[J]. 中国工业医学杂志, 2008, 21(5): 301-303.
14. 杨春燕, 段宇珠, 赵群远, 等. 急性砷化氢中毒并发急性胰腺炎5例分析[J]. 中外医学研究, 2013, 11(9): 108-109.
15. 孙德兴, 李晓凤, 谭河清, 等. 10例急性重度砷化氢中毒心肌损害临床分析[J]. 工业卫生与职业病, 2009, 35(5): 302-303.
16. 樊华, 孙德兴, 李法鹏, 等. 血液透析联合血液灌流治疗急性重度砷化氢中毒临床分析[J]. 中国工业医学杂志, 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. 彭静, 辜江. 急性砷化氢中毒合并中毒性心肌炎25例临床分析[J]. 中国实用医药, 2009, 4(8): 84-85.
19. 李森林, 李静华, 张智刚. 急性砷化氢中毒对胆道系统的影响[J]. 中华劳动卫生职业病杂志, 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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