急性草甘膦中毒患者临床特征及其毒物代谢浓度分析5例
Analysis of 5 patients with acute glyphosate poisoning clinical characteristics and metabolic concentration
窦建瑞 1杨燕 2张昊 3张锋 3赵义 4苗润丰4
作者信息
- 1. 扬州市疾病预防控制中心职业健康科,扬州 225001
- 2. 苏北人民医院全科医学门诊,扬州 225009
- 3. 江苏省疾病预防控制中心职业病防治所,南京 210009
- 4. 扬州大学附属医院急诊科,扬州 225012
- 折叠
摘要
目的 分析急性草甘膦中毒患者体内草甘膦(GLY)及其代谢产物氨甲基膦酸(AMPA)浓度变化与临床症状的相关性,为草甘膦毒性研究提供参考依据.方法 于2021年2月～7月收集扬州市三级甲等综合医院急诊科收治的5例口服草甘膦中毒患者入院时、住院期间的尿液,使用衍生化-气相色谱质谱联用法(HPLC-MS-MS)检测尿中GLY及AMPA浓度,结合患者临床表现和救治过程进行分析.结果 患者中毒后主要表现为急性消化道症状,如恶心、呕吐、腹痛等症状.患者尿样中的GLY的浓度都在第1天达到最大值,并且随着时间而逐渐降低,出院当天GLY最终浓度低于初始浓度的10％.出院时患者1、2、3、4体内GLY的清除率分别为96.97％、95.91％、96.87％和92.87％.结论 草甘膦进入人体后维持时间较短,中毒患者入院时草甘膦及其代谢产物的浓度与中毒剂量和临床症状之间的未显示相关性.
Abstract
Objective To analyze the correlation between changes in the concentration of glyphosate(GLY)and its metabolites(AMPA)in patients with acute glyphosate poisoning and clinical symptoms,and to provide reference for the study of glyphosate toxicity.Methods Urine samples from 5 patients with oral glyphosate poisoning admitted to the Emergency Department of Yangzhou Third Class A General Hospital from February to July 2021 were collected.Urine concentrations of GLY and AMPA were measured using derivatization gas chromatography-mass spectrometry,and analyzed based on the patient's clinical manifestations and treatment process.Results The main symptoms of the patient after poisoning were acute gastrointestinal symptoms,such as nausea,vomiting,abdominal pain,etc.The concentration of GLY in the patient's urine reached its maximum on the first day and gradually decreased over time.On the day of discharge,the final concentration of GLY was 10％lower than the initial concentration.At discharge,the clearance rates of GLY in cases 1,2,3,and 4 were 96.97％,95.91％,96.87％and 92.87％,respectively.Conclusion The glyphosate has a shorter maintenance time after entering the human body;There is no correlation between the concentration of glyphosate and its metabolites admitted to the hospital,the dose of poisoning,and clinical symptoms in poisoned patients.
关键词
草甘膦/氨甲基膦酸/中毒/代谢浓度/衍生化-气相色谱质谱联用法Key words
Glyphosate/Aminomethyl phosphonic acid/Poisoning/Metabolic concentration/HPLC-MS-MS引用本文复制引用
基金项目
扬州市科技计划社会发展项目(YZ2022084)
江苏省职业健康科研项目(JSZJ20231209)
江苏省卫生健康委医学科研项目(N2020178)
江苏省医学重点学科建设项目(ZDXK202249)
出版年
2024
NETL
NSTL
万方数据