| Abstract [eng] |
Paracetamol is the most common cause of the poisoning in the USA and other European countries. In these countries paracetamol related liver injuries causes large number of cases of hospitalization and deaths. Treatment of paracetamol poisoning depends on ingested paracetamol dose, the time of admission to the hospital ant the other factors that increases risk of hepatotoxicity. A common perception is that patient-reported dosages are unreliable in the context of acute overdose. Only small number articles concerning the validity of patient reported dose are published. Investigation of the blood biochemical markers and investigation of their changes are important in order to treat the poisoning and prevent liver injuries. Prevalence of paracetamol poisoning is not known in Lithuania. Prevalence of liver injuries caused by paracetamol poisoning is not known as well. The aim of the study is to investigate the changes of blood biochemical markers in patients poisoned by paracetamol. The frequency of analyses of blood biochemical markers was analyzed; levels of blood biochemical markers were analyzed in the different time periods according to the admission to the hospital time and the time after paracetamol ingestion. Levels of blood biochemical markers were compared in the groups of self –poisoned patients and suicidal patients. Calculation of correlation coefficients between levels of blood biochemical markers and patient reported paracetamol dose was performed. In the group of patients with acute poisoning frequency of performed analyses of AST, ALT activity, the total bilirubin and blood cloth analyses was 62-85 percent in 12 hours after paracetamol ingestion. These analyses were performed for 46 percent of patients in 48-96 hours after paracetamol poisoning. In patients who were admitted to the hospital later than 12 hours after paracetamol ingestion, levels of AST in 24-120, ALT in 48-120 hours and levels of total bilirubin in 72-96 hours after paracetamol ingestion were higher than in patent who were admitted to the hospital earlier. In the group of patient who were admitted to the hospital later than 12 after paracetamol ingestions, levels of AST, ALT increased between 12-24 and 24-48 hours and between 48-72 and 72-96 hours. In this group of patients the decrease of SPA between 12-24 and 72-96 hours after paracetamol ingestion was found. A higher prevalence of toxic hepatitis and higher AST activity in 48-72 hours after paracetamol ingestion was found in self-poisoned patients comparing to suicidals. Calculated coefficients of correlation have shown a strong and significant correlation between AST, ALT activity, total bilirubin levels and patient reported paracetamol dose. A high frequeancies of hepatotoxicity and deaths were found in group of patients who used paracetamol for a long time period (more than 24 hours). A significant increase of AST between 24-48 and 48-72 hours after manifestiation of clinical symptoms of poisoning was found. |
